| NPI | 1750038337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDANA SMALLBERG Co Owner 516-997-3636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2022-03-03 |
| Last Update Date | 2022-05-06 |