| NPI | 1477006476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAHRAM ELAAHI Owner 845-641-7028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 056515-1) |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2016-07-27 |