| NPI | 1760964787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ESPINAL Billing Manager 718-428-6060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 054990) |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2018-09-06 |