| NPI | 1699934646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J ANCONA President/Dentist 954-434-3229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: DN8648) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN8648) |
| 1223G0001X Dentist, General Practice (Licence: FL DN18066) | |
| 122300000X Dentist (Licence: FL DN18677) | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2011-01-20 |