| NPI | 1841735685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY KINGSBERG Owner 954-288-8582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 22329) |
| Enumeration Date | 2017-01-04 |
| Last Update Date | 2017-01-09 |