| NPI | 1912355660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANAND SHAH General Dentist 321-914-0929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN 19903) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2016-06-02 |