| NPI | 1578684866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS I. RALLIS Member 718-631-7800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223P0300X Dentist, Periodontics | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2025-09-11 |