| NPI | 1720482755 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | VANESSA MARTINEZ Office Manager 516-365-3535  | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: NY 035133-1)  | 
| Enumeration Date | 2014-10-20 | 
| Last Update Date | 2014-10-20 |