| NPI | 1720009848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN BAZOS President 954-255-2787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DS 12263) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2007-08-27 |