| NPI | 1336249739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHALEEN GRANT Administrative Director 212-241-0806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-08-22 |