| NPI | 1043632318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN R ACKER Owner 718-370-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 036474) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2014-05-20 |