| NPI | 1063554251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVONNE A MINCHING Partner 718-507-1440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 045339) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 044573) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-08-22 |