| NPI | 1821961582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARUNESH CHAKOTE Member 516-474-7958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2025-09-27 |
| Last Update Date | 2025-09-27 |