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Organization
PROFESSIONAL DENTAL OFFICE PC.
Active
Organization
PROFESSIONAL DENTAL OFFICE PC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSA IDALIA DIAZ DDS, (PRESIDENT)
(212) 673-9367
Entity
Organization
Contact information
Practice address
167 RIVINGTON ST, 1ST FLOOR, NEW YORK, NY 10002-2555
(212) 673-9367
(212) 673-9367
Mailing address
167 RIVINGTON ST, 1ST FLOOR, NEW YORK, NY 10002-2555
(212) 673-9367
(212) 673-9367
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
048431-1
NY
Other
Enumeration date
01/29/2007
Last updated
09/05/2013
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