# JUAN CARLOS DEFEX, DDS PLLC

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

## Provider details

- **NPI number:** 1437469459
- **Authorized official:** JUAN CARLOS DEFEX DDS (OWNER)
- **Authorized official phone:** (718) 476-6750

## Contact information

- **Practice address:** 7410 35TH AVE, SUITE 106W, JACKSON HEIGHTS, NY 11372-8197
- **Practice address phone:** (718) 476-6750
- **Practice address fax:** (718) 426-4040
- **Mailing address:** 7410 35TH AVE, SUITE 106W, JACKSON HEIGHTS, NY 11372-8197
- **Mailing address phone:** (718) 476-6750
- **Mailing address fax:** (718) 426-4040

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 043060-1 | NY | Yes |

## Other

- **Enumeration date:** 10/08/2010
- **Last updated:** 10/08/2010