| NPI | 1366601189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HECTOR BOLIVAR BERNABE Dentist/President 718-716-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 043696) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2008-06-06 |