| NPI | 1447971379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARREN FLOWERS Officer 516-640-7401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| 1223X2210X Dentist, Orofacial Pain | |
| Enumeration Date | 2022-09-08 |
| Last Update Date | 2026-02-09 |