| NPI | 1821291873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY JON WAYNE Owner 561-443-7001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL 13403) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2014-11-03 |