| NPI | 1457874588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANA LASTRES Owner 239-594-1171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN21762) |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2022-07-21 |