| NPI | 1841764313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEWIS CHEN Practice Partner 917-513-6419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 122300000X Dentist |
| 1223G0001X Dentist General Practice | |
| 124Q00000X Dental Hygienist | |
| 126800000X Dental Assistant | |
| Enumeration Date | 2019-01-17 |
| Last Update Date | 2020-02-10 |