| NPI | 1619833159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY THEOGENE Owner/Pediatric Dentist 954-610-9441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2025-12-29 |
| Last Update Date | 2025-12-29 |