| NPI | 1568784270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADELENE MICHELLE TRUJILLO Owner 305-264-0747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN18770) |
| Enumeration Date | 2010-02-22 |
| Last Update Date | 2015-11-20 |