| NPI | 1780895417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY B MINTZER Administrator 212-744-1409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 28718) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |