| NPI | 1114797578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNEY TORRES Manager 786-400-9011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-01-08 |
| Last Update Date | 2024-01-08 |