| NPI | 1417013509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT A CONVISSAR Partner 212-255-5730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 35183) |
| Enumeration Date | 2006-12-31 |
| Last Update Date | 2020-08-22 |