| NPI | 1639541659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAFAEL G BALBOA Dentist 305-503-5122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN20434) |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2015-10-29 |