| NPI | 1902275647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE LUIS CHAVIANO General Dentist 305-967-2175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN21485) |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2015-09-23 |