| NPI | 1518234392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MILLER President 631-499-7266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 041250) |
| Enumeration Date | 2011-11-22 |
| Last Update Date | 2011-11-22 |