| NPI | 1053955260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INESSA KANDOV Owner/Orthodontist 718-423-2626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2019-10-30 |