| NPI | 1144926221 |
|---|---|
| Doing Business As | GREAT NECK DENTAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | LORRAINE MATHEUS Credentialing 781-562-0457 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2023-02-01 |
| Last Update Date | 2024-09-17 |