| NPI | 1760812556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI N CARTER Office Manager 561-495-2099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL 9129) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: FL 9191) |
| 1223E0200X Dentist Endodontics (Licence: FL 6099) | |
| 1223E0200X Dentist Endodontics (Licence: FL 10823) | |
| Enumeration Date | 2013-11-15 |
| Last Update Date | 2015-10-16 |