| NPI | 1922480102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN SCHUSHEIM President 516-509-4732 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 056152) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2015-06-23 |