| NPI | 1841550258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAYA BERSHADSKY Office Manager 718-336-6112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 028653) |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2012-05-18 |