| NPI | 1457718215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISABELLA TERRASSA REYES Owner 939-475-6629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.029465) |
| Enumeration Date | 2016-01-25 |
| Last Update Date | 2016-01-25 |