| NPI | 1770881807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIDDIQUR RAHMAN Dentist 718-384-1671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 043271) |
| Enumeration Date | 2011-03-15 |
| Last Update Date | 2011-03-15 |