| NPI | 1639417801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IBELKA VARGAS Owner 212-568-1003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 050317-1) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 052543) |
| Enumeration Date | 2013-01-23 |
| Last Update Date | 2013-01-23 |