| NPI | 1659002129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM DAVID SHATZ Owner 516-536-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2023-03-07 |