| NPI | 1831236223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL ALAN GORNSTEIN Owner 561-967-0476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: FL DN15413) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-08-22 |