| NPI | 1619793593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRECY MARTINEZ Doctor/Authorized Official 212-491-6940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center Oral and Maxillofacial Surgery |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2024-11-25 |
| Last Update Date | 2024-11-25 |