| NPI | 1174925903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA HENAO Dentist/Owner 305-570-1777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN 17090) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2014-09-24 |