| NPI | 1992823207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY A THOMSEN Owner President Dentist 407-847-2103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL 12975) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: FL 13033) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2007-11-28 |