| NPI | 1063673143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEANA RAPOPORT Office Manager 845-517-2358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2011-09-20 |