| NPI | 1609124213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY JON WAYNE President 561-443-7001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN13403) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2012-08-29 |