| NPI | 1760784854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH JAMES CERAVOLO Periodontist 561-790-5700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL 10720) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: FL 12671) |
| Enumeration Date | 2010-11-23 |
| Last Update Date | 2010-11-23 |