| NPI | 1710140116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN H LEE Owner 631-724-7575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: NY 050381) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2008-07-07 |