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General NPI Number Information
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NPI Number | 1588135826
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Entity Type | Organization
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Legal Business Name | GIL DECHAVEZ DDS PC
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Dates
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Enumeration Date | 12/16/2018
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Last Update Date | 12/16/2018
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Provider Practice Location Address
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Address Line | 8812 55TH AVE
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City | ELMHURST
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State | NY
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Zip | 11373-4437
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Country | US
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Telephone | 718-271-6148
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Fax | 718-271-6164
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Provider Business Mailing Address
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Address Line | 8812 55TH AVE
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City | ELMHURST
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State | NY
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Zip | 11373-4437
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Country | US
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Telephone | 718-271-6148
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Fax | 718-271-6164
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MARGARITA R LOZANO
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Credential |
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Telephone | 718-271-6148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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