| NPI | 1902633696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHOHREH GHASEMI Owner 954-376-2412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery |
| 207Y00000X Otolaryngology | |
| Enumeration Date | 2024-09-17 |
| Last Update Date | 2024-09-17 |