| NPI | 1255670196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER GEORGE MIHALIOS Owner 718-279-8202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 052418-1) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: NY 0557791) |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2013-02-13 |