| NPI | 1487715504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFFORD R BROWN Owner 631-587-7373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2020-12-31 |