| NPI | 1174109425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH NEIL SULLIVAN Director Of Patient Revenue 212-686-3686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2021-03-18 |
| Last Update Date | 2021-03-18 |