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General NPI Number Information
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NPI Number | 1831491745
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Entity Type | Organization
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Legal Business Name | ALFONSO DENTAL OFFICE. P.C.
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Dates
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Enumeration Date | 11/29/2010
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Last Update Date | 11/29/2010
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Provider Practice Location Address
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Address Line | 100-102 POST AVENUE 204TH ST GROUND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10034-3406
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Country | US
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Telephone | 646-796-2727
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Fax | 646-796-2777
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Provider Business Mailing Address
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Address Line | 100-102 POST AVENUE 204TH ST GROUND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10034-3406
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Country | US
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Telephone | 646-796-2727
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Fax | 646-796-2777
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Authorized Official
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Title or Position | DENTIST
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Name | DR. CARLOS ALFONSO
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Credential | D.D.S
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Telephone | 646-796-2727
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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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