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 |