| NPI | 1407002264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANETTE DIAZ Medical Biller 212-838-0090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2017-05-03 |