| NPI | 1992664437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIC MOREL-MAYNARD President 917-703-8220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2026-01-20 |
| Last Update Date | 2026-01-20 |