| NPI | 1124119870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE MOLININI Office Manager 718-356-7878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 26709) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 37859) |
| 1223G0001X Dentist, General Practice (Licence: NY 50463) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-08-22 |