| NPI | 1083220123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN S PUN Managing Member 347-592-1120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2025-02-05 |