NPI | 1295621399 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL P JUBAN Owner 225-229-6260 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
Enumeration Date | 2025-06-16 |
Last Update Date | 2025-06-16 |