| NPI | 1225507320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE MARKEY Owner 347-558-5299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2018-11-19 |
| Last Update Date | 2018-11-19 |