| NPI | 1760494678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA ELENA LOZANO Director 305-379-6037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: FL ME88197) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2008-07-09 |