| NPI | 1740428374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY B GRILLO President/Owner 305-682-1414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN11083) |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2009-02-04 |