| NPI | 1205868098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ANGELO SCIALABBA Chief Clinical Officer 561-512-2709 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA 13328) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery |
| 1223E0200X Dentist, Endodontics | |
| 1223G0001X Dentist, General Practice | |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223P0300X Dentist, Periodontics | |
| 1223P0700X Dentist, Prosthodontics | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2021-06-21 |