| NPI | 1831506708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA OUSTATCHER Owner 718-256-0022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 050956) |
| Enumeration Date | 2014-07-12 |
| Last Update Date | 2014-07-12 |