| NPI | 1487192340 |
|---|---|
| Doing Business As | VIDA DENTAL SPA |
| Entity Type | Organization |
| Authorized Contact | MARIA TERESA IOANNOU Owner 917-842-9807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 050794) |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2017-02-10 |