| NPI | 1114818051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL CAMACHO Vice President 954-962-8311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2025-07-10 |
| Last Update Date | 2025-07-10 |