| NPI | 1891407011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GISLEDA A RAMOS Owner 772-485-9759 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2022-12-28 |