| NPI | 1679868905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONELLE COX President 917-604-6748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 054522) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2011-06-15 |