| NPI | 1053468793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA R C PERRATTO Dentist 631-382-2495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 0411161) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 0416301) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-08-22 |