| 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 |