| NPI | 1235991639 |
|---|---|
| Doing Business As | SOUTH SHORE DENTAL |
| Entity Type | Organization |
| Authorized Contact | GREGORY BANGIYEV Owner 646-206-8414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health |
| Enumeration Date | 2024-01-30 |
| Last Update Date | 2024-01-30 |