| NPI | 1659573442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG L LEVINE Oral Surgeon 631-665-1325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2017-08-28 |