| NPI | 1003113655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALOMON ISRAEL Owner 772-569-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN0013953) |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2016-10-26 |