| NPI | 1538510862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORGE ENRIQUE MESA Dentist 954-384-7505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist Dental Public Health (Licence: FL DN12634) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2016-06-28 |