| NPI | 1154691541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GITLIN Owener 516-579-8950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 041069) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-01-03 |