| NPI | 1588158539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE MIKHLY Owner 917-974-8445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02529300) |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2018-06-21 |