| NPI | 1285869933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA PICCONE Insurance Coordinator 561-826-2002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN16134) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN17306) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2010-07-15 |