| NPI | 1992078521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE NELSON-MANGATAL Dentist 786-316-5044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN16582) |
| Enumeration Date | 2012-02-13 |
| Last Update Date | 2012-02-13 |