| NPI | 1467655290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELL DAVID KOONIN Doctor 718-375-1133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 035909) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2009-11-03 |