| NPI | 1750752507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARROL ANN FENN Owner 561-686-3335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2015-10-19 |