| NPI | 1487196739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILAF AL MAWALDI Dentist 716-866-7011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 000072-1) |
| Enumeration Date | 2016-11-16 |
| Last Update Date | 2016-11-16 |