| NPI | 1497802284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH COLLAZO President 954-385-5855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN0012295) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN0011940) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2008-11-19 |