| NPI | 1407319239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARAMARZ KHALILI Owner 516-382-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2019-04-09 |