| NPI | 1538353271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRA ELLIOT GOLDBERG Member 516-484-1123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 051130) |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2007-09-05 |