| NPI | 1366644718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAUDIA A. MAHON-VAZQUEZ Owner 631-348-1501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: NY 043487) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2019-03-12 |