| NPI | 1962641241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVAN E TERRERO Owner 239-498-6780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN 5380) |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2014-07-29 |