| NPI | 1982728176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SMITH President 845-297-3950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NY 041539) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 038631) |
| 122300000X Dentist (Licence: NY 027264) | |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2025-09-11 |