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 |