| NPI | 1780067637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY M DURAN Office Manager 954-389-2345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 13474) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 19566) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2015-07-09 |