| NPI | 1770696270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE GOMEZ Provider Relations 305-274-2499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223E0200X Dentist Endodontics |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2017-01-13 |