| NPI | 1265999379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON WILLIAMS Owner 954-478-9319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics |
| 1223D0001X Dentist, Dental Public Health | |
| 1223D0004X Dentist, Dentist Anesthesiologist Speciality | |
| 1223G0001X Dentist, General Practice | |
| 1223P0106X Dentist, Oral and Maxillofacial Pathology | |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223P0300X Dentist, Periodontics | |
| 1223P0700X Dentist, Prosthodontics | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 1223X0008X Dentist, Oral and Maxillofacial Radiology | |
| 124Q00000X Dental Hygienist | |
| 125J00000X Dental Therapist | |
| 126800000X Dental Assistant | |
| 126900000X Dental Laboratory Technician | |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2019-02-25 |