| NPI | 1679844583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE R OUELLETTE Owner 561-659-5566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 9470) |
| Enumeration Date | 2012-01-24 |
| Last Update Date | 2012-01-24 |