| NPI | 1649230210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY SIANO Billing Insurance Corrdinator 2399-938-3025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2010-09-16 |