Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Dental |
261QD0000X |
| NPI Number | 1871726331 |
| LBN Legal business name | ESTHETIC FAMILY DENTISTRY PC |
| Authorized official | DANIEL MENSER - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 09/01/2009 |
| Last updated | 09/01/2009 - About 17 years ago |
| Identifiers | n/a |
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