| NPI | 1023362811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUSTORGIO A LOPEZ President 786-375-1449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: FL ME74506) |
| Enumeration Date | 2012-11-01 |
| Last Update Date | 2012-11-01 |