| NPI | 1811186505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN E BEREY Orthodontist 212-249-3780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 051463) |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2007-10-18 |