| NPI | 1609122357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE LUIS LEON RAMIREZ Vice President 863-294-7648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN18539) |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2014-08-21 |