| NPI | 1295009447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW MARON Owner 718-439-2876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 18369) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 027990) |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2012-03-06 |