| NPI | 1932318144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY WAYNE KENNEDY Dr. 631-499-3377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 039664) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2009-03-20 |