| NPI | 1942556337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NGA K VAN Dentist 407-281-1119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: FL dn17986) |
| Enumeration Date | 2012-08-03 |
| Last Update Date | 2012-08-03 |