| NPI | 1174132880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIONEL NOEL VERA-CARABALLO Pediatric Dentist Office Manager 516-602-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2020-07-28 |