| NPI | 1467737684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY D. BLUM Owner 305-538-4556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL L11000065863) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: FL L11000065863) |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2011-10-19 |