| NPI | 1396142709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYLVESTER ANTHONY EVANGELISTA Owner 718-544-5055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 48294) |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2014-12-01 |