| NPI | 1184791238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRABHA KRISHNAN Secretary 914-969-0015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 044502) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NY 043558) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2020-08-22 |