NPI | 1174948723 |
---|---|
Entity Type | Organization |
Authorized Contact | STEPHANIE GOMEZ Provider Relations Specialist 305-274-2499 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 1223E0200X Dentist, Endodontics |
1223S0112X Dentist, Oral and Maxillofacial Surgery | |
1223P0221X Dentist, Pediatric Dentistry | |
Enumeration Date | 2014-02-19 |
Last Update Date | 2014-08-06 |