| NPI | 1255019444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RESHMA BADDALOO Dentist 305-302-9688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Additional Taxonomies | 1223E0200X Dentist Endodontics |
| 1223G0001X Dentist General Practice | |
| 1223P0106X Dentist Oral and Maxillofacial Pathology | |
| 1223P0221X Dentist Pediatric Dentistry | |
| 1223P0300X Dentist Periodontics | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2023-07-07 |
| Last Update Date | 2023-07-07 |