| NPI | 1760642284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVAN EDUARDO TERRERO President 917-796-7624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN17477) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2008-06-10 |