| NPI | 1295522753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | A M SOHAL MAHAMUD Chief Executive Officer 929-350-7495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2025-04-21 |
| Last Update Date | 2025-05-23 |