| NPI | 1750820635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CELESTINE FERNANDEZ-VIVES Owner 917-689-5713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ 22D102314100) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-02-13 |