| NPI | 1659444339 |
|---|---|
| Doing Business As | COUNTRY ICLES DENTAL |
| Entity Type | Organization |
| Authorized Contact | ERIKA A MARTINEZ President Owner 954-384-8222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN14334) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2014-07-23 |