| NPI | 1669795332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER MATTHEW AMENEDO Owner 631-382-8585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 050522) |
| Enumeration Date | 2010-03-09 |
| Last Update Date | 2010-03-09 |