| NPI | 1356091516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE L CUSACK Senior Vice President & CFO 516-321-6058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2022-03-28 |