| NPI | 1831453182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ESPINAL Billing Department 718-739-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 046075-1) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 038476-1) |
| 122300000X Dentist (Licence: NY 054990-1) | |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2012-07-02 |