| NPI | 1972624344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE HARRIS SULTAN Administrator 954-771-8772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: FL 10648) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |