| NPI | 1629159116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HADI ZIAEI Owner 631-499-5663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2011-02-17 |