| NPI | 1811412174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH ALLEN Member 212-753-3450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: NY 030107-1) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: NY 050942-1) |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2022-07-21 |