| NPI | 1366539587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM EMANUEL SUSSMAN Dentist 718-855-7545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 029705) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 33803) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2020-08-22 |