| NPI | 1528601747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH SANTIAGO Insurance/Credentialing Coordinator 305-258-9838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2019-10-21 |