| NPI | 1679065791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE RIZKALLA Dentist 347-977-3608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019031607) |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2018-06-04 |