| NPI | 1710497862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHANN RAMKISSOON Owner 386-752-2480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: FL 21272) |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2023-05-03 |