| NPI | 1952648396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSAY GREMILLION MAPLES President 904-880-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN18271) |
| Enumeration Date | 2013-01-04 |
| Last Update Date | 2013-01-04 |