| NPI | 1073908638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADVAIT SHAH Managing Member/ Dentist 516-380-9603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MD 15215) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2015-03-31 |