| NPI | 1427365204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL P LOGUE President/Oral Surgeon 954-941-2727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: FL DN12346) |
| Enumeration Date | 2010-09-01 |
| Last Update Date | 2010-09-01 |