| NPI | 1013446301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISABEL OLIVERA Dmd/Owner 954-727-9865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN18784) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2022-07-21 |