| NPI | 1013235068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON JAMES WICKS Owner 212-234-6088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 050804) |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2010-05-13 |