NPI | 1003046202 |
---|---|
Entity Type | Organization |
Authorized Contact | STEPHANIE GOMEZ Provider Relations Specialist 305-274-2499 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 122300000X Dentist |
1223E0200X Dentist, Endodontics | |
Enumeration Date | 2009-07-22 |
Last Update Date | 2014-08-04 |