| NPI | 1912168006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVIN R VELAZQUEZ Owner 718-898-6010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 045312) |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2008-06-20 |