| NPI | 1730532607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN ROBERTSON Owner 516-747-2535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 042619-1) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2016-07-20 |