| NPI | 1265815054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY P CHEN Owner/Dentist 954-236-5273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL dn16682) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL dn91444) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL dn15943) | |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2015-06-30 |