| NPI | 1780822783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA I. JUAREZ Pediatric Dentist 631-670-6035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 049452-1) |
| Enumeration Date | 2009-01-29 |
| Last Update Date | 2009-01-29 |