| NPI | 1245525351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN J PESANTES President 718-850-1011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 046461) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2011-06-16 |