| NPI | 1982005120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AKIVA BERSSON Owner 845-371-0093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: NY 057282) |
| Enumeration Date | 2014-09-08 |
| Last Update Date | 2014-09-08 |