| NPI | 1295161164 |
|---|---|
| Doing Business As | THE DENTAL BOUTIQUE |
| Entity Type | Organization |
| Authorized Contact | CARLOS J. HUERTA President/Owner 646-649-3116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2013-09-23 |
| Last Update Date | 2013-09-23 |