| NPI | 1811776636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEJANDRO WILLIAMS Owner 718-294-3725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2023-09-22 |
| Last Update Date | 2023-09-22 |