| NPI | 1841582160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARJAN MOGHADAM Dentist 917-658-5863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CT 010388) |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2011-05-04 |