| NPI | 1760618284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANG PHAM Manager 646-400-3630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 30-022960) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2009-06-10 |