| NPI | 1750951299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA SAMUELSON CEO 561-859-5052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2021-06-28 |
| Last Update Date | 2023-07-10 |