| NPI | 1114635331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIONEL NOEL VERA-CARABALLO Pediatric Dentist 516-602-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2022-11-07 |