| NPI | 1417116013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY D HAIMSON Owner 718-429-0440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 042896) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2008-06-09 |