| NPI | 1265315592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AHMED MANSOUR Owner/Orthodontist 917-209-6466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2025-07-25 |
| Last Update Date | 2025-09-24 |