| NPI | 1437469459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN CARLOS DEFEX Owner 718-476-6750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 043060-1) |
| Enumeration Date | 2010-10-08 |
| Last Update Date | 2010-10-08 |