| NPI | 1174202329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY L JACOBSON CEO 845-369-3703 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Additional Taxonomies | 1223D0004X Dentist Dentist Anesthesiologist |
| 1223G0001X Dentist General Practice | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2023-07-14 |
| Last Update Date | 2023-07-14 |