| NPI | 1851654677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL G MAUCK Owner 561-790-0206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: FL DN9881) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2012-06-18 |