| NPI | 1073030755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVAN PELTON Clinical Director 305-220-8911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN5838) |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2017-08-24 |