| NPI | 1255320305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANA RIVERA Office Manager 718-562-1074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 035661) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2020-08-22 |