| NPI | 1871997106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISOL RUIZ President 561-395-0550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN0012544) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: FL DN7316) |
| 1223P0300X Dentist, Periodontics (Licence: FL DN8339) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL DN19915) | |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2014-10-15 |