Individual
ELIAS ALTAGRACIA PIMENTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1600 MACOMBS RD, BRONX, NY 10452-2016
(718) 466-8800
(718) 466-8870
Mailing address
2181 WALLACE AVE., APT 6H, BRONX, NY 10462-1855
(718) 792-1218
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
053250-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02824371
—
NY
Enumeration date
07/27/2007
Last updated
07/27/2007
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