| NPI | 1972958635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEENAL H PATEL Presidnet 352-678-1453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2016-05-02 |