| NPI | 1245249598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA M GAHLES Manager 718-622-2695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 046884) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2020-08-22 |