| NPI | 1760763148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MASON KOSTINSKY Chief Operating Officer 212-246-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: NY 035303) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 033746) |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2011-08-30 |