| NPI | 1093941361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GITLIN VP 718-769-4116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 045231) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 041069) |
| Enumeration Date | 2009-06-01 |
| Last Update Date | 2009-06-01 |