| NPI | 1902077670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRIA REYNOSO President 718-507-9100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 0465601) |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2008-03-20 |