| NPI | 1568433464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ED MECKLER Chairman Of The Board 800-487-4867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223E0200X Dentist Endodontics |
| 1223G0001X Dentist General Practice | |
| 1223P0221X Dentist Pediatric Dentistry | |
| 1223P0300X Dentist Periodontics | |
| 1223P0700X Dentist Prosthodontics | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2020-08-22 |