| NPI | 1245828219 |
|---|---|
| Doing Business As | OC DENTAL SPA |
| Entity Type | Organization |
| Authorized Contact | DERICK PHAM Owner Dentist 631-693-9040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-01-06 |
| Last Update Date | 2021-01-06 |