| NPI | 1710257811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN SOSNICK Owner 631-261-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 050904) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 054986) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 050868) | |
| Enumeration Date | 2012-01-05 |
| Last Update Date | 2012-01-05 |