| NPI | 1740979319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUN FREDERICK DARRAH Pediatric Dentist Owner 631-398-9376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2023-05-01 |
| Last Update Date | 2023-05-01 |