| NPI | 1962870147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY NGUYEN LE Dentist/Owner 850-532-7815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL dn20335) |
| Enumeration Date | 2015-09-04 |
| Last Update Date | 2016-07-15 |