| NPI | 1063879559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA M JAQUEZ Owner 954-430-0308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN17593) |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2016-01-28 |