| NPI | 1104217553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY COSENZA Owner 631-287-8687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 043391) |
| Enumeration Date | 2015-02-06 |
| Last Update Date | 2015-02-06 |