| NPI | 1467837401 |
|---|---|
| Doing Business As | FAMILY MEDICAID DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | MARK A HERMAN Doctor 561-498-0015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL 14310) |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2016-02-04 |