| NPI | 1992504856 |
|---|---|
| Former Legal Business Name | PHILIP D PACK, DMD |
| Entity Type | Organization |
| Authorized Contact | PHILIP DAVID PACK Owner 212-683-4476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2025-03-12 |
| Last Update Date | 2025-03-12 |