| NPI | 1710161161 |
|---|---|
| Other Name | SCHOOL HEALTH PROGRAM |
| Entity Type | Organization |
| Authorized Contact | CHARLES BROCKET Administrator 718-920-4167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2007-12-20 |