| NPI | 1881969442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUES M. DOUECK President 718-339-7982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2012-06-11 |