| NPI | 1952629834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER ALTON Dentist 904-448-0441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL FLDN13024) |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2010-05-17 |