| NPI | 1083935381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 50 050013) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 10777) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NH 02369) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO 9601) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 30-01-8046) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS026161L) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA DN17420) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 019-022019) | |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2021-12-15 |