| NPI | 1417078437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOURDES MIRABAL Insurance Consultant 954-438-3803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN0014735) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2010-09-10 |