| NPI | 1598993321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILSE WERNER BERUBE President 321-723-0671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN14259) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2009-07-01 |