| NPI | 1467839522 |
|---|---|
| Doing Business As | DENTASTIC DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | PAUL R SHEPARD Manager 954-781-4670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN7571) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN19680) |
| 122300000X Dentist (Licence: FL DN19879) | |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2015-04-28 |