| NPI | 1518505692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA COOPER Insurance COO Rdinator 561-658-4100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-12-19 |
| Last Update Date | 2021-06-02 |