| NPI | 1598361115 |
|---|---|
| Doing Business As | MY TAMARAC DENTIST |
| Entity Type | Organization |
| Authorized Contact | FLOR LUZARDO Dentist 786-451-9171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-12-09 |
| Last Update Date | 2020-12-11 |