| NPI | 1720784002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH THAYIL Owner 954-655-6368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 1223D0001X Dentist Dental Public Health | |
| 1223D0004X Dentist Dentist Anesthesiologist | |
| 1223E0200X Dentist Endodontics | |
| 1223P0106X Dentist Oral and Maxillofacial Pathology | |
| 1223P0221X Dentist Pediatric Dentistry | |
| 1223P0300X Dentist Periodontics | |
| 1223P0700X Dentist Prosthodontics | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| 1223X0008X Dentist Oral and Maxillofacial Radiology | |
| 1223X2210X Dentist Orofacial Pain | |
| 124Q00000X Dental Hygienist | |
| 126800000X Dental Assistant | |
| 126900000X Dental Laboratory Technician | |
| Enumeration Date | 2023-02-07 |
| Last Update Date | 2023-02-08 |