| NPI | 1538770672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INNA GELLERMAN Owner 718-631-0508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2020-08-12 |