| NPI | 1073902045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERNANDO GUTIERREZ Dentist 954-432-6222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 124Q00000X Dental Hygienist | |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2015-01-14 |