| NPI | 1780898627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAYSA K AZIZ Dentist 718-494-6060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 0430541) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 042457) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2013-12-23 |