| NPI | 1487198040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE CRISCUOLO Dmd/Owner 954-268-9825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN19581) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN21814) |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2016-12-15 |