| NPI | 1992596811 |
|---|---|
| Former Legal Business Name | PINES DENTAL PA |
| Entity Type | Organization |
| Authorized Contact | RODOLFO OLMOS Owner 407-951-0335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2025-05-13 |
| Last Update Date | 2025-05-13 |