| NPI | 1154853927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENRIQUE ACOSTA President 786-368-6212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN17284) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN17284) |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2017-04-20 |