| NPI | 1518189117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IAN ANDREW GLASER President 631-724-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 036700) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2010-03-18 |