NPI | 1225140718 |
---|---|
Entity Type | Organization |
Authorized Contact | STEPHANIE GOMEZ Provider Relations 305-274-2499 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics |
Additional Taxonomies | 1223E0200X Dentist, Endodontics |
1223G0001X Dentist, General Practice | |
1223S0112X Dentist, Oral and Maxillofacial Surgery | |
Enumeration Date | 2006-08-31 |
Last Update Date | 2014-08-19 |