| NPI | 1295264216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NADIIA SHUBINA Office Manager 718-265-6699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: NY 054409) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2022-07-21 |