| NPI | 1972912327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELL J. FARR Dr. 954-974-4101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: DN11255) |
| Additional Taxonomies | 122300000X Dentist (Licence: DN10716) |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2014-08-11 |