| NPI | 1811017718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA C. TERAN Dentist 1718-651-8686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 041326) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2014-05-19 |