NPI | 1831634583 |
---|---|
Entity Type | Organization |
Authorized Contact | MOHAMED SIRAGE Owner 954-856-3745 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN19581) |
Additional Taxonomies | 122300000X Dentist (Licence: FL DN21814) |
Enumeration Date | 2017-01-04 |
Last Update Date | 2017-01-04 |