| NPI | 1518636935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILMA PAGAN President 939-400-1387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-09-09 |
| Last Update Date | 2022-07-21 |