| NPI | 1275925653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY MORSE SANDERS Vice President 631-369-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 39244) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 39273) |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2015-02-23 |