| NPI | 1134561137 |
|---|---|
| Doing Business As | 125 ST. BRACES |
| Entity Type | Organization |
| Authorized Contact | DANIEL KUNCIO Member 646-505-8852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: NY 051019) |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2013-07-19 |