| NPI | 1457508897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PERRY M. IACOVETTI President 718-224-0040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 050882) |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2008-08-27 |