| NPI | 1679968408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN C PETERSON President 516-536-5777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 029836-1) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2015-07-20 |