| NPI | 1811121379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM SPOSATO Administrator 914-245-4332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: NY 049967) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: NY 048328) |
| 1223P0300X Dentist, Periodontics (Licence: NY 051732) | |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2009-05-12 |