| NPI | 1326872417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INGMAR ANDREA HERNANDEZ Owner Dentist 239-408-3636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2024-08-29 |
| Last Update Date | 2024-08-29 |