| NPI | 1275793317 |
|---|---|
| Doing Business As | KINGS HIGHWAY DENTAL |
| Entity Type | Organization |
| Authorized Contact | GREGORY JEROME HASKIN President 718-692-4791 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 0399641) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 0399641) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2008-06-12 |