| NPI | 1194469197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NISHAT SHAHABUDDIN Director 917-757-0981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2022-04-25 |