| NPI | 1255920435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAMEETA IDNANI Dentist 516-721-8327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-01-13 |
| Last Update Date | 2022-07-11 |