| NPI | 1639057201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAYNE B. MARTIN Owner 917-748-0816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2025-08-22 |
| Last Update Date | 2025-08-22 |