| NPI | 1912318320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK SANDERS Owner 305-598-3384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN18428) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN17737) |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2014-05-20 |