| NPI | 1851921068 |
|---|---|
| Other Name | WESTPORT FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | REBEKAH LYNN BROWDER Owner 917-292-0502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2020-01-16 |