| NPI | 1124554332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRANCE STRADFORD Nmm 718-727-0274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 040944) |
| Enumeration Date | 2017-05-08 |
| Last Update Date | 2017-05-08 |