| NPI | 1386971968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN WADE GILBERT Owner 516-239-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 029102) |
| Enumeration Date | 2009-11-03 |
| Last Update Date | 2009-11-03 |