| NPI | 1790053023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD PASQUAL Office Manager 561-900-9080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2011-12-01 |