| NPI | 1063624344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA BOYLE Contact 212-873-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 035905) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 036361) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2016-06-07 |