| NPI | 1790448827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANEL MORALES Office Administrator 954-682-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| 124Q00000X Dental Hygienist | |
| Enumeration Date | 2021-10-15 |
| Last Update Date | 2021-10-15 |