| NPI | 1487072708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILIA ROGERS Administrator 917-912-7139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 056612) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2014-04-03 |