| NPI | 1760459598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERNANDO SAN JUAN President 305-662-8995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN 11002) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2020-08-22 |