| NPI | 1174629521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAMBIZ ALI ZANGENEH Owner 845-569-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 041119) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 042635) |
| 122300000X Dentist (Licence: NY 048694) | |
| 1223E0200X Dentist, Endodontics (Licence: NY 048701) | |
| 1223P0300X Dentist, Periodontics (Licence: NY 052403) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 040518) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 045097) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 037164) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2007-07-24 |