| NPI | 1013409002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EJLAL ALALAWI Owner/Provider 914-325-5672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center Oral and Maxillofacial Surgery |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2018-06-05 |