| NPI | 1104911775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN JASON BRODNER President 561-746-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL dn14999) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |