| NPI | 1932488749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAHRIAR MOINAMINI Owner Dentist 718-708-7171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 052054) |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2011-08-10 |