| NPI | 1730391129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT LOUIS SHPUNTOFF Authorized Official 718-229-5924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2007-05-05 |
| Last Update Date | 2014-01-24 |