| NPI | 1275735185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEETHA BALAMURUGAN President 631-264-2610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 049539-1) |
| Enumeration Date | 2007-06-03 |
| Last Update Date | 2020-08-22 |