| NPI | 1891021101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAHARAK FOOLADI President 718-403-0444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 052402-1) |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2009-10-20 |