SpecialtyPediatric Dentist
LocationPort Orange, FL
NPI1801183983
License statusActive
License number19854
License expires02/28/2028
Disciplinary recordClear
Last verified by WhoIsMyDentist: 2026-07-17. Sourced from the U.S. federal NPI registry and state dental board licensing (federal record dated 09/15/2014). If this looks outdated, use "Report an issue" on this profile to suggest a correction.