| NPI | 1811134893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOSES DAVID DATSON President 718-284-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 047288) |
| Enumeration Date | 2009-01-13 |
| Last Update Date | 2009-01-13 |