| NPI | 1952508707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER M PERCIBALLI President 631-756-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 048957) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 050095) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2020-08-22 |