| NPI | 1538370465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA E MEJIA Dentist 914-526-2144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 048450) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 048615) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |