| NPI | 1114185774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT MAIMONE Owner 212-228-2505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: NY 37188) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: NY 37188) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2008-05-29 |