| NPI | 1760631402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONTE D. MILLER Dentist/Partner 631-499-2112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 048254) |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2008-09-18 |