| NPI | 1467574871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PANAGIOTIS GLAVAS Owner 516-487-6453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 047563) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 047563) |
| 1223P0700X Dentist, Prosthodontics (Licence: NY 047563) | |
| Enumeration Date | 2007-04-05 |
| Last Update Date | 2010-04-30 |