| NPI | 1184737413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRY HAROLDO CANCIO President 8139-682-0699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN0010001) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2020-08-22 |