| NPI | 1033231295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW WITROCK Partner 631-928-2830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: NY 040514) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 042137) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2013-03-08 |