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Organization

DELEON DENTAL OFFICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSE RAFAEL DE LEON DDS (PRESIDENT)
(347) 443-5633
Entity
Organization

Contact information

Practice address
155 E MERRICK RD, VALLEY STREAM, NY 11580-5925
(516) 341-7088
Mailing address
60 E CARPENTER ST, VALLEY STREAM, NY 11580-4404
(516) 561-9459

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
046096
NY

Other

Enumeration date
11/19/2014
Last updated
11/19/2014
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