| NPI | 1205798030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARIEL AMINOV Director 516-512-3164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| 204E00000X Oral & Maxillofacial Surgery | |
| Enumeration Date | 2025-12-01 |
| Last Update Date | 2025-12-01 |