Individual
KIMBERLI LEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
425 GRAND ST, SUITE 1, NEW YORK, NY 10002-4700
(646) 908-5439
Mailing address
36 W 83RD ST, APT R, NEW YORK, NY 10024-5255
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
058745
NY
1223P0221X
Pediatric Dentistry
22DI02619400
NJ
Other
Enumeration date
02/25/2014
Last updated
03/06/2017
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