| NPI | 1750731303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS RAMOS Incorporator 267-979-7654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN014198) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2016-06-14 |