| NPI | 1760520852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE S. ROSEN Owner / President 718-451-1888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 035221) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2008-08-04 |