NPI | 1306108733 |
---|---|
Entity Type | Organization |
Authorized Contact | JAY FENSTERSTOCK President 631-724-0104 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 032077) |
Enumeration Date | 2012-06-12 |
Last Update Date | 2012-06-12 |