Individual
DR. JOSE ARISTIDES ROA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4071 DENMAN ST, ELMHURST, NY 11373-1608
(718) 476-1573
(718) 478-2485
Mailing address
4071 DENMAN ST, ELMHURST, NY 11373-1608
(718) 476-1573
(718) 478-2485
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
044819
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01460186
—
NY
Enumeration date
08/16/2005
Last updated
11/05/2012
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