| NPI | 1477269298 |
|---|---|
| Doing Business As | PINE RIDGE DENTAL ON WILES |
| Entity Type | Organization |
| Authorized Contact | SEAN TOMALTY Operations Mgr 561-789-6611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-01-25 |
| Last Update Date | 2023-01-25 |