| NPI | 1093805921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARMAINE JOHNSON-LEONG Dentist 954-566-7479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN15991) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-08-22 |