| NPI | 1033837315 |
|---|---|
| Doing Business As | 55 EAST VILLAGE DENTAL |
| Entity Type | Organization |
| Authorized Contact | CHRISTINE BRANIGAN Rcm Manager 631-696-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2022-08-22 |
| Last Update Date | 2023-01-03 |