| NPI | 1659820330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYNE EBERECHUKWU KALU President Owner 347-534-7416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: NC 9616) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2022-02-07 |