| NPI | 1124172853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOOSHANG ANVAR Owner 718-445-7030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 029182) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NY 046871) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2014-06-26 |