| NPI | 1942578067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARINELA NEMETZ Dentist 904-292-2210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN12937) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN15458) |
| Enumeration Date | 2011-12-03 |
| Last Update Date | 2011-12-03 |