| NPI | 1124280664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STELLA EI BE TAN Member 917-515-8226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: NY 0498641) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2008-06-26 |