| NPI | 1750010310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYAM WAHEED Dentist 516-840-0409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2022-06-08 |
| Last Update Date | 2022-06-08 |