| NPI | 1326550302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL LI Owner / Surgeon 347-943-1960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| 261QD0000X Clinic/Center, Dental | |
| Enumeration Date | 2017-10-30 |
| Last Update Date | 2017-10-30 |