| NPI | 1841475696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE GRADY Member 212-874-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: NY 046685) |
| Enumeration Date | 2007-12-28 |
| Last Update Date | 2007-12-28 |