| NPI | 1407397581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW L BELLAFIORE Owner 718-875-9424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 043328) |
| Enumeration Date | 2017-03-09 |
| Last Update Date | 2017-03-09 |