| NPI | 1033469135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SETH MARTIN BLACK Owner 212-593-2930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 033118) |
| Enumeration Date | 2012-09-15 |
| Last Update Date | 2012-09-15 |