| NPI | 1972930774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON A WITONSKY Managingmember 954-782-7911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN18938) |
| Enumeration Date | 2013-10-11 |
| Last Update Date | 2013-10-11 |