| NPI | 1922028729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA ANN HARRIS Office Manager 631-669-8855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 033669) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 024454) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-08-22 |