| NPI | 1902669567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER H CHEN Authorized Agent 914-722-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2024-02-05 |