| NPI | 1679620942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN VICTOR SOOTIN Owner 954-437-2040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN 16213) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2020-08-22 |