| NPI | 1205218559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL P COSTABILE Doctor 561-347-8266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN17978) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2015-06-23 |