| NPI | 1679934970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID S GAVLIN Dentist/Owner 917-750-8221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 048412) |
| Enumeration Date | 2016-03-14 |
| Last Update Date | 2021-07-19 |