| NPI | 1972931541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMED AL-JANABI Owner 718-333-5898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 053152) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 056648) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 271533) | |
| Enumeration Date | 2013-10-17 |
| Last Update Date | 2013-10-17 |