| NPI | 1821203472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELAINE CRUZ Supervisor 845-336-8478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 28057) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2008-09-24 |