| NPI | 1093958282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ZIDILE Periodontist 718-643-1953 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NY 052187) |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2013-10-01 |