| NPI | 1982575387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE BRANIGAN Credentialing Manager 631-451-7700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2025-09-17 |
| Last Update Date | 2025-09-17 |