| NPI | 1861723694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS MORTILLARO President 718-491-3901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 045148) |
| Enumeration Date | 2010-01-18 |
| Last Update Date | 2010-01-18 |