| NPI | 1275084345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE GOMEZ Credentialing Coordinator 305-274-2499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN22345) |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2016-10-24 |