| NPI | 1386910040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YATIN KHANNA Member 718-915-3713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 23707) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 21759) |
| 1223P0700X Dentist, Prosthodontics (Licence: NJ 23509) | |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2012-03-28 |