| NPI | 1033457783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY M LEE Owner 212-682-0770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 050640) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2013-01-30 |
| Last Update Date | 2013-05-06 |