| NPI | 1679723308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE ARISTIDES ROA President 718-476-1573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 044819) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2012-01-30 |