| NPI | 1134253040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONRAD V HIBBERT Dentist 954-435-6636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 13088) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |