| NPI | 1548410947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT S OLLER CEO Clinical Operations 954-262-4343 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health |
| 1223E0200X Dentist, Endodontics | |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223P0300X Dentist, Periodontics | |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2011-06-24 |