| NPI | 1720262496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN SHIN President 718-423-2248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 050531) |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2007-12-18 |