| NPI | 1043503949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA BUTO Business Manager 516-683-1870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 1223P0700X Dentist Prosthodontics | |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2011-05-25 |