| NPI | 1063918787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAQUEL M ROZDOLSKI Partner 917-903-1630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 122300000X Dentist |
| 1223D0004X Dentist, Dentist Anesthesiologist Speciality | |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2018-04-02 |