| NPI | 1083893721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICAHARD C DOUGLAS Owner 954-583-4447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN9789) |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2007-10-30 |