| NPI | 1215238183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID EIDMAN Director 718-429-7744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 039197) |
| Enumeration Date | 2010-11-09 |
| Last Update Date | 2010-11-09 |