| NPI | 1578807806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROY KERMIT KING President 561-747-5766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: FL DN7278) |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2012-11-27 |