| NPI | 1861773939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA ELIZABETH CARDENAS President 857-919-2485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA DN21061) |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2011-09-02 |