| NPI | 1790921062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN KONSTANTINE MANTINAOS Owner/Dentist Prosthodontist 718-361-3050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 5067165) |
| Enumeration Date | 2008-12-16 |
| Last Update Date | 2011-11-05 |