| NPI | 1780266734 |
|---|---|
| Doing Business As | INDIAN TRACE DENTAL |
| Entity Type | Organization |
| Authorized Contact | MARTHA VALENCIA Office Manager 954-217-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-04-28 |
| Last Update Date | 2021-04-28 |