| NPI | 1508140815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERIC ETHAN COHEN Owner 718-469-0014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 05-0085-1) |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2011-10-05 |