| NPI | 1609403021 |
|---|---|
| Doing Business As | MODERN DENTAL AND IMPLANTS |
| Entity Type | Organization |
| Authorized Contact | DEVAN DALLA CEO 646-427-6519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2020-07-01 |