| NPI | 1346412459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FABIOLA ANTILLANA REYES General Dentist 212-740-2800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: NY 048089) |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2008-03-28 |