| NPI | 1124280763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL F DI COSTANZO Dentist 212-688-6010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 048415-1) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2008-06-25 |