| NPI | 1982807889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERMINIA D. RODRIGUEZ President 386-775-4911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN 10606) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2022-07-21 |