| NPI | 1184996282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY JOHNSON Chief Operations Officer 212-697-0939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 036361) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2012-02-03 |