| NPI | 1801092341 |
|---|---|
| Other Name | MONTE PARK ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | CHARLES BROCKETT Administrator 718-920-4167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2020-08-22 |