| NPI | 1609921022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL KOKOLIS Dentist 7183-532-5582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 0496241) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2015-07-18 |