# CENTRO DENTAL DRA. REYES PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346412459
- **Authorized official:** DR. FABIOLA ANTILLANA REYES D.D.S (GENERAL DENTIST)
- **Authorized official phone:** (212) 740-2800

## Contact information

- **Practice address:** 1569 SAINT NICHOLAS AVE, NEW YORK, NY 10040-4261
- **Practice address phone:** (212) 740-2800
- **Practice address fax:** (212) 740-1900
- **Mailing address:** 1569 SAINT NICHOLAS AVE, NEW YORK, NY 10040-4261
- **Mailing address phone:** (212) 740-2800
- **Mailing address fax:** (212) 740-1900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 048089 | NY | Yes |

## Other

- **Enumeration date:** 03/28/2008
- **Last updated:** 03/28/2008