| NPI | 1871212738 |
|---|---|
| Doing Business As | LARCHMONT VILLAGE ORAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | PETER BALACKY Owner 646-756-9450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2022-08-24 |
| Last Update Date | 2024-04-02 |