| NPI | 1316343346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE RAFAEL DE LEON President 347-443-5633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 046096) |
| Enumeration Date | 2014-11-19 |
| Last Update Date | 2014-11-19 |