| NPI | 1972937613 |
|---|---|
| Doing Business As | ORAL & MAXILLOFACIAL SURGERY & DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER T. KELLS Associate Director Pobo 212-590-5741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2013-08-29 |