Individual
DR. JORGE L DELVALLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
25 AVE AT PORT IMPERIAL, APT. 621, WEST NEW YORK, NJ 07093-8350
(201) 803-6647
Mailing address
25 AVE AT PORT IMPERIAL, APT. 621, WEST NEW YORK, NJ 07093-8350
(201) 803-6647
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02479400
NJ
Other
Enumeration date
08/24/2011
Last updated
08/24/2011
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