| NPI | 1962949859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH DANIEL DEBIASE Owner 914-908-4939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 056765) |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2017-01-30 |