| NPI | 1730762642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHALOM BLOBSTEIN Dr/Owner 917-450-4990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2021-04-29 |