| NPI | 1861102329 |
|---|---|
| Doing Business As | DREAM DENTAL |
| Entity Type | Organization |
| Authorized Contact | RAFAEL KHAVIS Statutory Agent/Dentist 917-822-4185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-11-24 |
| Last Update Date | 2022-11-24 |