| NPI | 1700148103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY FENSTERSTOCK President 631-451-2245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 032077) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2012-06-12 |