| NPI | 1851049548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOVANI MIGUEL GONZALEZ Owner Dentist 954-394-8176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223E0200X Dentist Endodontics |
| 1223G0001X Dentist General Practice | |
| 1223P0300X Dentist Periodontics | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| 124Q00000X Dental Hygienist | |
| 126800000X Dental Assistant | |
| 126900000X Dental Laboratory Technician | |
| Enumeration Date | 2022-03-12 |
| Last Update Date | 2022-03-12 |