| NPI | 1578915369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA JOHANNA DE VERA Mgr 786-360-4768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN18847) |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2016-07-06 |