| NPI | 1578078630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURI STEIN Credentialing Dept. 954-994-0892 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2017-12-11 |
| Last Update Date | 2017-12-11 |