| NPI | 1023774668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE FREYTES Dentist 954-755-1222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2023-10-26 |