| NPI | 1821567256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM LEVINE President/Member 844-992-5446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2018-11-14 |
| Last Update Date | 2023-04-10 |