| NPI | 1275906232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROME VITALE Dentist/Owner 772-337-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL dn13975) |
| Enumeration Date | 2015-11-12 |
| Last Update Date | 2015-11-12 |