| NPI | 1497845440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA LORETTA NIELSEN Owner 561-683-6247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN0013591) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-08-22 |