| NPI | 1629616198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA SALAMA President 917-432-7523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2019-12-16 |