| NPI | 1215664339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW GIDALY Owner/Partner 516-848-6762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-08-08 |
| Last Update Date | 2022-08-08 |