| NPI | 1871174185 |
|---|---|
| Doing Business As | LEADING EDGE ORAL SURGERY BROADWAY |
| Entity Type | Organization |
| Authorized Contact | HIRO SORIANO CIO 516-344-5746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2021-04-19 |
| Last Update Date | 2021-04-19 |