| NPI | 1316463250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES NOTTINGHAM Owner/Practitioner 954-695-4333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2022-07-21 |