| NPI | 1962622332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG J PANOSSIAN Owner 516-541-4767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: NY 051170) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2008-05-28 |