| NPI | 1063630242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REN YAMAGATA President 212-867-1188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 043278) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |