| NPI | 1578114443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILLIE ACOSTA FERNANDEZ Practice Administrator 305-661-5297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2019-09-23 |