| NPI | 1881993392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW MARON Dentist 718-439-2876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2012-08-07 |