| NPI | 1184742298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE DIACOUMAKOS Owner 718-745-4422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-09-08 |