| NPI | 1275278467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIAS ALTAGRACIA PIMENTEL Employer 917-365-0513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-05-02 |
| Last Update Date | 2022-05-02 |