| NPI | 1164506028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK JOEL FISHMAN President 718-377-4884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: NY 029156) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2012-04-04 |