| NPI | 1780975474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARJANEH HAGHPASSAND-AZIN Dentist 631-427-1232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 045301-1) |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2011-04-28 |