| NPI | 1679985824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PILAR MARIA RIVERA Director Of Billing 631-499-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 0501662) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2014-05-22 |