| NPI | 1528720257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FEDERICO DIEZ Owner/Dentist 954-505-7631 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 1223E0200X Dentist, Endodontics | |
| 1223P0300X Dentist, Periodontics | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2021-10-11 |
| Last Update Date | 2021-10-11 |