| NPI | 1417332750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN R CISTERNAS Co President 718-635-0797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 052816) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NY 051246) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 049017) | |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2015-07-28 |