| NPI | 1003326513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN MERRELL President 954-309-9952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NC 8720) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 8720) |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2017-10-10 |