| NPI | 1669739801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RON PASQUAL Office Manager 561-900-9080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: FL DN17270) |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2012-04-12 |