| NPI | 1366796450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN CARLOS CASTELLANOS President 239-603-5210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN 19837) |
| Enumeration Date | 2012-10-29 |
| Last Update Date | 2016-04-28 |