| NPI | 1073155511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADELINE HOESTEN Vice President Of Integration 954-675-3088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-10-16 |
| Last Update Date | 2024-05-29 |