| NPI | 1881991214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH NINA Owner 718-429-6622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 050127-1) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 055474-1) |
| 122300000X Dentist (Licence: NY 048101-1) | |
| 1223G0001X Dentist, General Practice (Licence: NY 048800-1) | |
| 1223G0001X Dentist, General Practice (Licence: NY 052578-1) | |
| 1223G0001X Dentist, General Practice (Licence: NY 055242-1) | |
| Enumeration Date | 2011-02-21 |
| Last Update Date | 2012-01-09 |