Organization
3545 JOHNSON BLVD DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEJANDRO LEONEL WILLIAMS DDS (OWNER)
(718) 294-3725
Entity
Organization
Contact information
Practice address
1624 UNIVERSITY AVE BSMT, BRONX, NY 10453-6948
(718) 294-3725
Mailing address
1624 UNIVERSITY AVE BSMT, BRONX, NY 10453-6948
(718) 294-3725
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06804993
—
NY
Enumeration date
06/17/2022
Last updated
08/28/2024
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