| NPI | 1962826750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT MICHAEL ROTHENBERG Managing Member 347-989-2010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: DC DEN1001225) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: DC DEN1001223) |
| Enumeration Date | 2014-02-13 |
| Last Update Date | 2014-02-13 |