| NPI | 1376688473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH E. ROSS Periodontist 954-941-2277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN 0013427) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2020-08-22 |