| NPI | 1396868105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA D. ILAN President 845-354-6444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 051103) |
| Enumeration Date | 2007-04-08 |
| Last Update Date | 2020-08-22 |