| NPI | 1144598590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD DEUTSEN Principal Owner/Director 718-253-2300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 049859) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 049859) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2011-12-13 |