| NPI | 1124215470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINICK GARRETT ROARK Owner 787-948-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: PR 2379) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2008-11-17 |