Individual
KEVIN MEJIAS-AGOSTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1894 WALTON AVE, BRONX, NY 10453-6018
(718) 583-2700
Mailing address
PO BOX 1222, LAS PIEDRAS, PR 00771-1222
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
060376
NY
Other
Enumeration date
02/18/2017
Last updated
12/31/2019
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