| NPI | 1538530985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULI KAGAN Administrator 561-487-4440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN9646) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN19496) |
| 122300000X Dentist (Licence: FL DN20158) | |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2015-10-12 |