| NPI | 1205215225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARMAINE AUBREY JOHNSON-LEONG Owner 954-566-7479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN15991) |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2015-05-22 |