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Organization
PESANTES DENTAL PC
Active
Organization
PESANTES DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUAN J PESANTES D.D.S. (PRESIDENT)
(718) 850-1011
Entity
Organization
Contact information
Practice address
11109 JAMAICA AVE, RICHMOND HILL, NY 11418-2323
(718) 850-1011
(718) 850-6086
Mailing address
11109 JAMAICA AVE, RICHMOND HILL, NY 11418-2323
(718) 850-1011
(718) 850-6086
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
046461
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01738614
—
NY
Enumeration date
06/16/2011
Last updated
06/16/2011
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