| NPI | 1336686526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY P. BOADWAY Dentist/Owner 516-921-7444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 050578) |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2017-01-25 |