| NPI | 1407344567 |
|---|---|
| Doing Business As | MESA PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | DANIEL PONCE Owner 646-234-6578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2018-04-24 |