| NPI | 1093428757 |
|---|---|
| Doing Business As | PINE RIDGE DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | JENNY ORGANISTA Director Of Rcm 917-966-0422 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-12-27 |
| Last Update Date | 2022-12-27 |