| NPI | 1003457441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY LAU Dentist 917-667-1488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2019-10-08 |