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Dental implants

Dental Implants IN MIAMI

Dental implants are the most cost-effective and beneficial option for restoring missing or damaged teeth. When teeth are missing, patients often suffer from various problems, including a decrease in both their chewing ability and their self-confidence. While other replacement options can help patients smile again, dental implants are the only choice that can do so while also maintaining their oral health and completely restoring their oral function.

We know that for our patients, one of the most important things about dental implants is how the new teeth will feel and affect their lives.

We offer several dental implant procedures to restore your smile at Ambiance Surgical Arts Center in Miami, Florida. Dental implants are designed to be inserted into your jaw to replace a missing or damaged tooth. Patients lose teeth for a variety of reasons, but implants are a highly successful treatment that creates a sense of uniformity in basic daily activities, such as eating, drinking, smiling, and speaking. The ideal candidate to receive dental implants would be missing one or more teeth but still healthy enough to undergo a surgical procedure.
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Biologic tooth extractions

TOOTH EXTRACTION IN OUR OFFICE IN MIAMI

It is always our goal to save our patients’ natural teeth whenever possible. However, from time to time, a tooth becomes too decayed or damaged, and it must be extracted. Fortunately, technology, technique and anesthesia have come a long way over the years, enabling us to provide you with a safe, comfortable and quick extraction right here in our office.
 

COMMON CONDITIONS RESULTING IN EXTRACTION:

  • Severe Decay
  • Periodontal Disease
  • Fractures
  • Impacted Teeth
  • Orthodontic Preparation
 

THE IMPORTANCE OF NATURAL TEETH

As mentioned above, saving your natural teeth is always our preference, as they play a significant role in the health of your jawbone, which requires regular stimulation to maintain bone structure. A missing tooth will quickly lead to jawbone loss. For this reason, Dr. Hines may recommend a special grafting procedure at the same time as your extraction to prevent jawbone loss and provide favorable conditions for an implant down the road.
 

HAVING A TOOTH EXTRACTED

The process of tooth extraction includes local anesthesia so that you don’t feel any pain, and additional anesthesia as needed to keep you comfortable throughout the procedure. The procedure itself typically takes less than an hour, and results and recovery are very safe and predictable.
 

RECOVERY AND HOME CARE

The most important things to know about recovery from a tooth extraction are:
  • Blood Clots: It is very important to form a strong blood clot following surgery. You can help the process by biting on a gauze pad for about 30 minutes following the procedure.
  • Straws and Smoking: Do not use straws (or tobacco products) for several days following the surgery, as this will dislodge the clot, resulting in a very painful condition called “dry socket.”
  • Pain: As the anesthesia wears off, you may experience soreness for a few days. Patients are typically able to manage the pain adequately with over the counter pain medications such as Ibuprofen. Any necessary prescription medicines will be discussed prior to your surgery.
  • *Note: Specific tooth extraction home care instructions will be given prior to surgery, and we are here to answer any additional questions you have.
If you’ve been told you need an extraction, you’re not alone – in fact, most people will have a tooth extracted at some point during their life. Dr. Hines is here to provide you with the best care possible – offering a safe, seamless experience – please call us at 786-377-4344 with any questions.
Exposure of canines

EXPOSURE OF IMPACTED TEETH IN MIAMI

WHAT IS AN IMPACTED TOOTH?

The maxillary cuspid (upper canine) is the second most common tooth to become impacted. The cuspid tooth is a critical tooth and plays an important role in your “bite”. The cuspid teeth are very strong biting teeth and have the longest roots of any human teeth. They are designed to be the first teeth that touch when your jaws close together so they guide the rest of the teeth into the proper bite.

Normally, the maxillary cuspid teeth are the last of the “front” teeth to erupt into place. They usually come into place around age 13 and cause any space left between the upper front teeth to close tighter together. If a cuspid tooth gets impacted, every effort is made to get it to erupt into its proper position. The techniques involved to aid eruption can be applied to any impacted tooth in the upper or lower jaw, but most commonly they are applied to the maxillary cuspid (upper canine) teeth. Sixty percent of these impacted teeth are located on the palatal (roof of the mouth) side of the dental arch. The remaining impacted teeth are found in the middle of the supporting bone, but are stuck in an elevated position above the roots of the adjacent teeth, or are out to the facial side of the dental arch.

Orthodontic Extractions
When a patient has extreme crowding, they may benefit from extractions prior to orthodontic treatment. This will give the teeth enough room to shift into their ideal places without putting stress on the surrounding teeth. Dr. Hines is an expert in orthodontic extractions and can safely and gently remove the necessary tooth, or teeth, to ensure your braces or Invisalign treatment will be a success

 Molar Uprighting
Molar uprighting is a procedure that’s used to correct a tilted molar. It’s typically performed on a second molar when it gets caught, or partially impacted, below the back of the first molar. Dr. Hines can perform a surgical procedure to reposition or upright the tooth. Either after or, occasionally during the surgical procedure, an orthodontic bracket can be attached to the tooth. Your orthodontist will then shift the tooth into its proper place along with the rest of your teeth.

 Expose, Bond and Bracket
For certain impacted teeth, Dr. Hines can perform surgery to expose the tooth and bond an orthodontic bracket to it. While any tooth can become impacted, most commonly we perform exposing and bracketing on an impacted maxillary cuspid, or upper eyetooth.

First, your orthodontist ensures there is space for the tooth to move into its proper place in the dental arch. Then, Dr. Hines will lift the gum above the impacted tooth to expose the hidden tooth underneath. Once the tooth is exposed, Dr. Hines bonds a bracket to it. The bracket may have a tiny gold chain attached to it, which will be hooked onto the orthodontic arch wire. Dr. Hines will suture the gum tissue so that there is space for the tooth to exit. After surgery, your orthodontist will attach a rubber band to the chain to apply a light, eruptive pulling force on the impacted tooth, slowly moving it into place.
Oral pathology

ORAL PATHOLOGY IN MIAMI

The inside of the mouth is normally lined with a special type of skin (mucosa) that is smooth and coral pink in color. Any alteration in this appearance could be a warning sign for a pathological process. The most serious of these is oral cancer.

The following can be signs at the beginning of a pathological process or cancerous growth:
  • Reddish patches (erythroplasia) or whitish patches (leukoplakia) in the mouth
  • A sore that fails to heal and bleeds easily
  • A lump or thickening on the skin lining the inside of the mouth
  • Chronic sore throat or hoarseness and/or difficulty in chewing or swallowing
These changes can be detected on the lips, cheeks, palate, and gum tissue around the teeth, tongue, face, and/or neck. Pain does not always occur with pathology, and curiously, is not often associated with oral cancer. However, any patient with facial and/or oral pain without an obvious cause or reason may also be at risk for oral cancer.

We would recommend performing an oral cancer self-examination monthly. Remember that your mouth is one of your body’s most important warning systems. Do not ignore suspicious lumps or sores. Please contact us so we can assist you with any questions or concerns.
Snoring apnea

Obstructive Sleep Apnea in Miami, FL 

People with obstructive sleep apnea (OSA) have disrupted sleep and low blood oxygen levels. When obstructive sleep apnea occurs, the tongue is sucked against the back of the throat. This blocks the upper airway and airflow stops. When the oxygen level in the brain becomes low enough, the sleeper partially awakens, the obstruction in the throat clears, and the flow of air starts again, usually with a loud gasp.

Repeated cycles of decreased oxygenation lead to very serious cardiovascular problems. Additionally, these individuals suffer from excessive daytime sleepiness, depression, and loss of concentration.

 Sleep Apnea Treatment
The first step in treatment for sleep apnea resides in recognition of the symptoms and seeking appropriate consultation. Oral and maxillofacial surgeons offer consultation and treatment options.

In addition to a detailed history, the doctors will assess the anatomic relationships in the maxillofacial region. With cephalometic (skull x-ray) analysis, the doctors can ascertain the level of obstruction. To confirm the amount of cardiovascular compromise and decreased oxygenation levels, a sleep study may be recommended to monitor an individual overnight.

What is MARPE?
Miniscrew-assisted rapid palatal expansion (MARPE) is an effective non-surgical and non-extraction treatment approach for that allows us to make dramatic changes in the size of a patients jaw including adults.  This process can be incredibly beneficial when treating cases of dental crowding and restricted airways.

Usually a dental surgeon will install the implants and an orthodontist will design the MARPE device and manage the expansion procedure.

Conventional maxillary expander treatments are common to treat narrow maxilla. However, these are limited to children because the suture holding the maxillary bone together fuses around 12-15 years of age. MARPE is innovative because it can be used on young adults whose suture has already fused since it directly connects the expander to the palatal bone.

How does MARPE work?
MARPE works by expanding the palatal bone which in turn decreases nasal resistance and gives the tongue more room to sit upwards and forwards in the mouth, making the airway larger to counteract obstructive sleep apnea.

This process is achieved by placing a custom-made maxillary expander and mini-screws along the midpalatal suture. The procedure typically lasts 20-30 minutes under local anesthesia. Pain is minimal and can be managed with an over the counter painkiller for 1-2 days. After installation, the patient will activate the expander every day for 4-6 weeks by turning a screw.

The expander will split the suture, and a gap will form between the front teeth. Orthodontic treatment will close the gap and help achieve a stable bite. The expander will remain in place until the new bone at the suture forms in 4-6 months.

Why Consider MARPE?
MARPE avoids undesirable tooth movement and attains greater bone expansion while minimizing dental side effects. In doing so, MARPE can achieve maximum airflow and reduce symptoms of Obstructive Sleep Apnea.

In more complex cases, the bones of the upper and lower jaw may be repositioned to increase the size of the airway (orthognathic surgery). This procedure is done in the hospital under general anesthesia and requires a one to two day overnight stay in the hospital.

OSA is a very serious condition that needs careful attention and treatment. Most major medical plans offer coverage for diagnosis and treatment.

MARPE Instructions
Tmj our services page

TMJ DISORDERS IN MIAMI

If you are experiencing pain, discomfort, or popping in your jaw when opening your mouth to talk or eat, you may have a TMJ (temporomandibular joint) disorder.
 

The temporomandibular joint, more commonly called the TMJ, is the joint that allows you to move your jaw around smoothly. Sometimes, the TMJ can develop disorders, making it difficult for your jaw to function comfortably. At Ambiance Surgical Arts Center of Miami, our oral and maxillofacial surgeon can help diagnose and treat TMJ disorders(TMD).


The exact cause of a TMD disorder isn't always clear, but early diagnosis and treatment can help prevent more serious problems later on. Sometimes, treatments can be simple lifestyle changes, but if nonsurgical management is not successful, surgery may be considered to relieve the tension in the jaw joint.

SYMPTOMS OF TMD
TMD refers to an entire family of disorders that can develop in and around your jaw joint. You may have a TMD if you have one or more of the following symptoms:
  • Difficulty opening your mouth all the way
  • Tightness around the jaw, or the jaw snapping shut when closing the mouth
  • Clicking or grating sounds when opening and closing the jaw
  • Headaches
  • Ear pain or hearing problems, such as ringing in the ears
  • Pain, discomfort, and dysfunction in the jaw joint and surrounding muscles
 

TREATMENT FOR TMD

Usually, a combination of treatments and lifestyle changes will be the best way to control the symptoms of a TMJ disorder. First, Dr. Hines will consider nonsurgical options, such as resting the jaw, exercises, splint therapy/nightguard management, medication management, steroidal and Botox injections and jaw physiotherapy.

Splint Therapy
Splint therapy is a non-invasive treatment approach aimed at managing TMD and associated symptoms. Splint therapy involves the use of a custom-made oral appliance, called a splint or occlusal splint, to alleviate symptoms and promote proper jaw alignment and function.


Digital Impressions
Planmeca Emerald S digital scanning to view three-dimensional images of the inside of your mouth.  Emerald S digital imaging is a state-of-the-art technology that captures high-quality images of your teeth and supporting structures, making it easy to diagnose problems and provide effective treatments. Say good bye to gagging, goopy impressions.
3d image

3D Imaging or CBCT Scan in Miami, FL

CONE BEAM CT SCAN


The Planmeca ProMax 3D Mid system gives our oral and maxillofacial practice state-of-the-art technology to help.

Our unit includes Ultra Low Dose™ – a proprietary low dose 3D imaging protocol that enables CBCT imaging with an even lower patient radiation dose than standard panoramic imaging.

Cone Beam Computed Tomography (CBCT) is a specialized imaging technique used in dentistry and maxillofacial surgery. It helps to capture three-dimensional images of the oral and facial structures. Unlike traditional dental X-rays, CBCT provides a detailed and comprehensive view of the teeth, jaws, temporomandibular joints, and surrounding tissues. It enables our dentist in Miami, FL, to diagnose and plan treatments with greater precision. CBCT scans utilize a cone-shaped X-ray beam that rotates around the patient, capturing a series of images from multiple angles. These images are then reconstructed into a 3D digital model. It helps with a thorough evaluation of dental issues, impacted teeth, bone abnormalities and implant planning. With its reduced radiation exposure and improved diagnostic capabilities, CBCT has become an invaluable tool in modern dentistry that enhances patient care and treatment outcomes.
Prf

PLATELET RICH PLASMA IN MIAMI

Platelet rich fibrin (PRF) is a by-product of blood (plasma) that is rich in platelets.  We offer PRF to most of our patients, making it available with dental implants, bone grafting, sinus lifts, palatal defects, fistula repair, full arch restoration, wisdom teeth removal, and other procedures. There are several benefits that you can anticipate from PRF treatments, including:
  • Eases your recovery process, reducing any physical discomfort you experience.
  • Abbreviates your recovery, resulting in a shorter recovery period than you would have otherwise.
  • Return to your normal activities and diet more quickly.

WHY ALL THE EXCITEMENT ABOUT PRP/PRF?


PRF/PRF permits the body to take advantage of the normal healing pathways at a greatly accelerated rate. During the healing process, the body rushes many cells and cell-types to the wound in order to initiate the healing process. One of those cell types is platelets. Platelets perform many functions, including formation of a blood clot and release of growth factors (GF) into the wound. These growth factors; platelet derived growth factors (PDGF), transforming growth factor beta (TGF), and insulin-like growth factor (ILGF), function to assist the body in repairing itself by stimulating stem cells to regenerate new tissue. The more growth factors released and sequestered into the wound, the more stem cells are stimulated to produce new tissue. Thus, PRP permits the body to heal faster and more efficiently.

A subfamily of TGF, is bone morphogenic protein (BMP). BMP has been shown to induce the formation of new bone in research studies in both animals and humans. This is of great significance to the surgeon who places dental implants. By adding PRP, and BMP, to the implant site with bone substitute particles, the implant surgeon can now grow bone more predictably and faster than ever before.

PRP/PRF HAS MANY CLINICAL APPLICATIONS


PRP/PRF can be used to aid bone grafting for dental implants. This includes onlay and inlay grafts, sinus lift procedures, ridge augmentation procedures, closure of cleft and/or lip, and palate defects. It can also assist in repair of bone defects created by removal of teeth, or small cysts and repair of fistulas between the sinus cavity and mouth.
 

PRP/PRF ALSO HAS MANY ADVANTAGES

 
  • Safety: PRP/PRF is a by-product of the patient’s own blood, therefore, disease transmission is not an issue.
  • Convenience: PRP/PRF can be generated in the doctor’s office while the patient is undergoing an outpatient surgical procedure such as the placement of dental implants.
  • Faster healing: The supersaturation of the wound with PRP/PRF, and thus growth factors, produces an increase of tissue synthesis and faster tissue regeneration.
  • Cost effectiveness: SincePRP/PRF harvesting is done with only 10 cc of blood in the doctor’s office, the patient need not incur the expense of the harvesting procedure in hospital or at a blood bank.
  • Ease of use: PRP/PRF is easy to handle and actually improves the ease of application of bone substitute materials and bone grafting products by making them more gel-like.
  •  

FREQUENTLY ASKED QUESTIONS ABOUT PRP/PRF


Is PRP/PRF safe? Yes. During the outpatient surgical procedure a small amount of your own blood is drawn out via the IV. This blood is then placed in the PRP centrifuge machine and spun down. In less than 15 minutes, the PRP is formed and ready to use.

Should PRP/PRF be used in all bone-grafting cases? Not always. In some cases, there is no need for PRP. However, in the majority of cases, application of PRP to the bone graft will increase the final amount of bone present, in addition to making the wound heal faster and more efficiently.

Will my insurance cover the costs? Unfortunately not. The cost of the PRP/PRF application is paid by the patient.

Are there any contraindications to PRP/PRF? Very few. Obviously, patients with bleeding disorders or hematologic diseases do not qualify for this in-office procedure. Check with your surgeon and/or primary care physician to determine if PRP/PRF is right for you.
Ankyloglossia

Frenectomy In Miami

What is Tongue Tie? 

Tongue tie, also known as ankyloglossia, is a condition that affects the movement of the tongue and is present at birth. It occurs when the frenulum, a small piece of tissue that connects the tongue to the floor of the mouth, is too short, tight, or thick. This can restrict the movement of the tongue and make it difficult to perform certain tasks, such as sticking out the tongue or moving it from side to side. In many cases there can be benefits to a tongue tie release procedure or frenuloplasty. 

 

Growth and Development of the Jaws and Tongue Tie

The tongue plays a critical role in growth and development of the mouth buy putting pressure on the palate and dental arches. Tongue tie decreases this pressure and is associated with a small mouth, palate and dental arches. Tongue tie is usually seen in cases of crooked teeth and severe orthodontic problems. Tongue tie can cause problems with breastfeeding, speaking, and eating. Tongue tie is also associated with mouth breathing, teeth clenching and TMJ problems since the mouth does not grow as large as it should. Usually the palate does not widen enough and it is high-vaulted. A small palate is linked to poor nasal breathing and upper airway resistance problems.

 

Palatal Expanders and Myofunctional Therapy

Mouth breathing, airway problems, TMJ and orthodontic problems are best treated with a combination of palatal expanders, myofunctional therapy and breathing exercises.  Our most popular adult expanders are Homeoblock and DNA appliances. Posture is often compromised and a chiropractor or physical therapist may be helpful in the treatment process.

 

Tied tongue can also lead to issues with oral hygiene, as the tongue may not be able to reach all parts of the mouth to clean it properly. In some cases, tongue tie may be corrected with a simple procedure to release the frenulum, which is called a frenotomy. In most cases myofunctional therapy will be necessary to restore proper tongue posture and function.

 

Different types of tongue ties:

Posterior tongue tie, Anterior tongue tie and Lip tie 

This type of tongue tie occurs when the frenulum is attached to the front of the tongue. Anterior tongue tie can cause problems with breastfeeding and eating, as the tongue may not be able to reach the roof of the mouth or move food around in the mouth effectively.

 

Lip tie

This is a type of tongue tie that affects the frenulum of the upper lip, causing problems with breastfeeding, completion of orthodontic braces, and speaking. A Lip tie connects the lip in a very tight way to the upper and lower jaw. Lip ties can impair nasal breathing and retrude the lower jaw.

 

Symptoms of tongue tie:

 
  • Difficulty breastfeeding or maintaining a latch
  • Mouth Breathing
  • Teeth Clenching
  • Poor Sleep
  • Crowded and Crooked Teeth
  • Bad Posture
  • Inability to stick out the tongue past the lower lip
  • Difficulty with certain sounds, such as “s” and “t”
  • Problems eating certain foods, such as those that require chewing
  • A tongue that appears notched or heart-shaped when sticking out
 

Tongue Untie/Frenectomy Procedure:


Treatment for tongue tie may involve a simple procedure called a frenectomy. Frenectomies involve releasing the frenulum to allow the tongue to move more freely. Frenectomies are usually performed with hurt very little and cause minimal bleeding.
Iv sedation

ANESTHESIA IN MIAMI

What is IV Conscious Sedation?
At Ambiance Surgical Arts Center, one of our top priorities is keeping you comfortable and safe throughout your procedure. To achieve this goal, we provide several anesthesia and sedation options, including IV sedation. This helps you “sleep” through your surgery without experiencing any anxiety, physical discomfort, and without having any unwanted memories later on. A combination of medications will be administered intravenously. In just minutes you will fall into a deep state of relaxation (twilight zone) and experience virtually no discomfort during treatment we will provide a pleasant and comfortable oral surgical visit without fear and apprehension.

Is IV Sedation Safe?
At Ambiance Surgical Arts Center, we take every precaution to ensure your safety, including an initial consultation and medical review to verify your eligibility for a safe IV procedure. Additionally, our staff members are fully trained in CPR and emergency protocols.

What do expect for recovery from IV Conscious Sedation?
Although you will be very drowsy, you will be conscious and breathing on your own and you will be able to communicate with our staff during the procedure. Your vital signs and cardiac rhythm are monitored during the sedation to ensure everything is running with ease. After the dental procedure most patients have no memory of the appointment day. For this reason, you must have someone to provide a ride you home once are discharged from surgery.

At Ambiance Surgical Arts Center, we value your comfort. To find out more about our approach to sedation, we invite you to schedule a consultation at 786-377-4344.
Zygomatic implants

Zygomatic Implants in Miami

Signs
Have your face, cheeks or lips begun to sink? If you wear dentures, are they loose or do you need adhesives to stabilize them? Do you contemplate facial surgery to prevent age lines? If so, you may be showing signs indicating the need for Zygomatic Implants.

Zygomatic Implant Benefits
Zygo Implants allow patients who otherwise would not be implant candidates to receive treatment to bring them back to form and function. Best of all, because Zygomatic Implants are placed directly in the zygoma bone and do not require grafting, the integration time is significantly reduced, meaning that your case will be done significantly faster than traditional Implants or the All on 4 implants.  You will be back to full form function and eating all those foods you miss in no time!

Zygomatic implants are an alternative to more traditional implants which involve drilling directly into the jawbone. Instead of doing this, the Zygomatic implants are much longer than traditional implants. They are anchored in the upper jawbone, which is close to the dense zygoma bone. This difference in location means that Zygomatic implants can provide a secure foundation for your dental implants while traditional dental implants may not be possible. People with deteriorated jaws may not be able to find success with traditional implant surgery. Advancements with Zygomatic implants means it can still be possible.
Get smooth  tight and flawless skin with morpheus8  the latest in skin resurfacing technology

Skin Rejuvenation with Morpheus8 and Evoke of Miami and Fort Lauderdale

At Ambiance Surgical Arts Center, we are proud to offer the revolutionary Morpheus8 radiofrequency microneedling treatment, a cutting-edge solution for achieving younger-looking, firmer, and smoother skin without the need for invasive surgery.  Our providers work under the supervision and direction of Dr. Jerri Hines and are trained directly by InMode, the makers of Morpheus8.  Your skin can easily be damaged by sun exposure, environmental toxins, skin disorder

Key Benefits of Morpheus8:  
Effective Skin Tightening: Morpheus8 delivers radiofrequency energy deep into the skin, stimulating collagen production and promoting tissue remodeling. This leads to improved skin tightness, reducing the appearance of wrinkles and fine lines.

Customizable Treatment: We understand that each individual’s skin concerns are unique. With Morpheus8, we can tailor the treatment to address specific areas of concern, such as the face, neck, or body. The system’s adjustable microneedle depth allows us to precisely target different layers of the skin, ensuring optimal results.  We also are very conservative in our approach to the face and would never allow our providers to use any high power settings in areas we want to preserve native fat, like the upper cheeks.

Minimal Downtime: Unlike surgical procedures, Morpheus8 requires minimal downtime, allowing you to resume your daily activities almost immediately. You may experience some mild redness or swelling, which typically subsides within a few days, revealing a more youthful and rejuvenated appearance.  Everyone is unique in how they heal, so downtimes do vary from person to person.

Why Choose Ambiance Surgical Arts Center for Morpheus 8 of Miami, FL?
Long term natural results:  The movement in cosmetics is leaning away from the excess of fillers over a long period of time and replacing them with medical grade microneedling and lasers.  Once done with your series of 3-5 treatments of Morpheus, we recommend quarterly treatments of Morpheus8 or noninvasive treatments such as Evoke.  Using medical grade skin care, suncreen, and hats are crucial in improving your results without the use of expensive fillers every 6-9 months.

Comprehensive Care: Your satisfaction and well-being are our top priorities. Our team will provide you with a personalized consultation, understanding your specific concerns and goals, to develop a customized treatment plan tailored to your needs.

Safety as a top concern:  This procedure is extremely safe, however there are some risks for skin of color, people with metal/silicone implants, and uncontrolled medical conditions.  These are gone over in your consultation which may include prepping your skin with a hydroquinone cream for 6 weeks, not being a candidate for the machine, or even referring you to our neighboring medical esthetician/dermatologist for a procedure that would suit you better.  We want your results to be amazing and don’t want to waste your time and money if you would benefit with another treatment or provider.  We at Ambiance Surgical Arts Center want to simplify beauty and are not above working with other members of our medical community to help you.

Schedule Your Consultation Today to allow Dr. Hines to help you with skin rejuvenation using Morpheus8 and Evoke by calling 786-377-4344.
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(786) 377-4344
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