| NPI | 1073871281 |
|---|---|
| Former Name | AVA ROSENBLOOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 058330-1) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2019-07-10 |