| NPI | 1932483864 |
|---|---|
| Doing Business As | MAIN STREET CHILDREN'S DENTISTRY OF BOCA RATON |
| Entity Type | Organization |
| Authorized Contact | MELVYN GOBER CEO 305-274-2499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2012-07-10 |