| NPI | 1285724427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL C GREEN VP 1718-823-7312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 037918) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 026669) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2020-08-22 |