| NPI | 1043661440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET BODEY Manageing Member 646-360-4840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2018-02-12 |