| NPI | 1609210178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE AMBROSE HAYLING President 347-774-7800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 051827-1) |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2013-04-26 |