| NPI | 1750449393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT FRIEDMAN Owner 718-767-7276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NY 042587) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 034366) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2020-08-22 |