| NPI | 1023531647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESUS LOZA Owner 954-609-6611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN00202793) |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2022-07-21 |