| NPI | 1144407602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED J COLOMBO Dentist / Partner 516-799-1787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 021404-1) |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2011-05-05 |