| NPI | 1740431980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH W. BRADSHAW President 561-630-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: FL DN13872) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: FL DN16549) |
| 1223E0200X Dentist, Endodontics (Licence: FL DN13841) | |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2008-10-07 |