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General NPI Number Information
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NPI Number | 1740451418
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Entity Type | Organization
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Legal Business Name | CLINICA DENTAL ACUARO, P.C.
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Dates
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Enumeration Date | 03/20/2008
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Last Update Date | 03/20/2008
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Provider Practice Location Address
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Address Line | 336 FORT WASHINGTON AVE SUITE 1B
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City | NEW YORK
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State | NY
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Zip | 10033-6803
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Country | US
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Telephone | 212-781-9535
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Fax | 212-781-8600
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Provider Business Mailing Address
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Address Line | 336 FORT WASHINGTON AVE SUITE 1B
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City | NEW YORK
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State | NY
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Zip | 10033-6803
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Country | US
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Telephone | 212-781-9535
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Fax | 212-781-8600
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Authorized Official
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Title or Position | PRESIDENT/DENTIST
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Name | DR. FEDERICO A. PEREZ
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Credential | D.D.S.
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Telephone | 212-781-9535
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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 | 047127-1
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License Number State | NY
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