| NPI | 1043661796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLANCA MAIRENYSC CASTELLO POLO Owner 954-580-4367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN20938) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2016-06-23 |