| NPI | 1790224756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AVICHAI STERN Owner 718-909-7960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center Oral and Maxillofacial Surgery (Licence: NY 051512) |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2017-02-22 |