| NPI | 1609151455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH DENISE HUBERT Owner 347-403-9930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 053536) |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2011-10-12 |