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General NPI Number Information
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NPI Number | 1467505529
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Entity Type | Organization
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Legal Business Name | CENTRO DENTAL FAMILIAR PC.
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 04/24/2008
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Provider Practice Location Address
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Address Line | 37 42 90 STREET 1ST FLOOR
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372
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Country | US
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Telephone | 718-424-5559
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Fax | 718-426-2484
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Provider Business Mailing Address
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Address Line | 37 42 90 STREET 1ST FLOOR
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372
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Country | US
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Telephone | 718-424-5559
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Fax | 718-426-2484
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Authorized Official
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Title or Position | DENTIST
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Name | DR. LUZ A FILION
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Credential | D.D.S
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Telephone | 718-424-5559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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