| NPI | 1497025969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD LAMAR Business Manager 561-305-4180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 4565) |
| Enumeration Date | 2011-12-30 |
| Last Update Date | 2011-12-30 |