| NPI | 1629862347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA TATIANA SIMON Board Certified Pediatric Dentist 917-204-6756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Enumeration Date | 2025-04-07 |
| Last Update Date | 2025-04-07 |