| NPI | 1568608875 |
|---|---|
| Former Legal Business Name | LAGUNA ISLES DENTAL ASSOCIATES, P.A. |
| Entity Type | Organization |
| Authorized Contact | MONEEZE MUJTABA Dentist 954-680-5552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL dn17384) |
| 1223G0001X Dentist, General Practice (Licence: FL dn10651) | |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2009-09-16 |