| NPI | 1184071912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW CROUCH Office Manager 718-441-0049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 057816) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2016-05-23 |