| NPI | 1730422247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELA MODESTO Dentist/President 954-554-3490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN17097) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN 17097) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2013-04-03 |