| NPI | 1215518824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENRIQUE ACOSTA President Owner 786-353-9887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2024-06-04 |