| NPI | 1932489192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN ANTHONY GRANDILLO Dentist 631-666-0427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 048345-1) |
| Enumeration Date | 2011-08-19 |
| Last Update Date | 2011-08-19 |