| NPI | 1275238420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALVIN MUNDACKAL BABU Owner/Managing Member 347-952-5205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| 122300000X Dentist | |
| 1223D0004X Dentist, Dentist Anesthesiologist Speciality | |
| 1223P0221X Dentist, Pediatric Dentistry | |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2023-04-04 |