| NPI | 1366803215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS G. WIEDEMANN Clinical Assistant Professor 212-998-9667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2016-03-18 |