| NPI | 1225475494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER A COSTALOS President 718-238-9888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2013-05-29 |