| NPI | 1992127765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH BRUCE COOPERMAN Secretary 646-221-8944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 046957) |
| Enumeration Date | 2014-01-14 |
| Last Update Date | 2014-01-14 |