| NPI | 1154814143 |
|---|---|
| Former Legal Business Name | BOULEVARD DENTAL ASSOCIATES, LLC |
| Entity Type | Organization |
| Authorized Contact | CLAUDIO HERNANDEZ Doctor 954-538-9993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL dn12326) |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2018-06-13 |