| NPI | 1558942060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH AMBROSECCHIA Director 646-501-9352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2021-04-16 |