Organization
ETHICS DENTAL IPA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LIBIA R JIMENEZ D.D.S (PRESIDENT)
(212) 668-9532
Entity
Organization
Contact information
Practice address
600 W 146TH ST, GF, NEW YORK, NY 10031-4301
(212) 368-9532
(212) 368-2245
Mailing address
600 W 146TH ST, GF, NEW YORK, NY 10031-4301
(212) 368-9532
(212) 368-2245
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
045307-1
NY
Other
Enumeration date
07/06/2011
Last updated
07/06/2011
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