| NPI | 1043586779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS A MATOS President 772-600-5130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Additional Taxonomies | 122300000X Dentist |
| 1223D0001X Dentist Dental Public Health | |
| 1223E0200X Dentist Endodontics | |
| 1223G0001X Dentist General Practice | |
| 1223P0106X Dentist Oral and Maxillofacial Pathology | |
| 1223P0300X Dentist Periodontics | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics | |
| 124Q00000X Dental Hygienist | |
| 126800000X Dental Assistant | |
| 126900000X Dental Laboratory Technician | |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2012-03-27 |