| NPI | 1548046618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REINALDO VELEZ Owner 646-209-9996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2023-09-05 |
| Last Update Date | 2023-09-05 |