| NPI | 1528227410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMED MANSOORUL IMAM President 718-434-5678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 049149) |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2008-06-05 |