| NPI | 1922816107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISHA TAAVAR Owner 347-966-6300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-12-20 |
| Last Update Date | 2024-12-20 |