| NPI | 1184234023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL THOMAS SPADAFORA Co Owner/ Dentist 267-556-3081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2020-08-05 |
| Last Update Date | 2020-08-05 |