| NPI | 1386458636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ONAEDO ACHEBE Member 646-740-9607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2025-02-06 |
| Last Update Date | 2025-05-02 |