| NPI | 1679118590 |
|---|---|
| Doing Business As | GENTLE DENTAL PORT JEFFERSON |
| Entity Type | Organization |
| Authorized Contact | HIRO SORIANO CIO 516-344-5746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2019-11-14 |