| NPI | 1851803753 |
|---|---|
| Doing Business As | VANGUARD DENTAL |
| Entity Type | Organization |
| Authorized Contact | DIVA PUERTA Member Manager 516-739-4990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2017-10-31 |