| NPI | 1447614763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALIKA CREW President 267-258-8584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 053689) |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2016-04-12 |