| NPI | 1033660832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN MURRAY Orthodontist 631-617-3371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: ME 4259) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: ME 2394) |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2016-10-18 |