| NPI | 1497111504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMAR DE LA CRUZ Treasurer 305-643-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN11020) |
| Enumeration Date | 2016-01-05 |
| Last Update Date | 2016-01-05 |