NPI | 1164787636 |
---|---|
Entity Type | Organization |
Authorized Contact | MATT DALLMANN Billing Manager 212-206-6465 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 252964) |
Enumeration Date | 2012-07-10 |
Last Update Date | 2012-07-10 |