NPI | 1760693006 |
---|---|
Entity Type | Organization |
Authorized Contact | CHARMAINE ANDREA EVANS President 718-703-8496 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 044715) |
Enumeration Date | 2007-05-25 |
Last Update Date | 2020-08-22 |