| NPI | 1205256781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GILDA DUARTE Owner 917-326-1269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 055650) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 054412) |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2014-04-23 |