| NPI | 1033517909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVIN HENRY PEARSON Orthodontist 718-948-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2014-12-09 |
| Last Update Date | 2023-11-27 |