Organization
CENTRO DENTAL DRA. REYES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FABIOLA ANTILLANA REYES D.D.S (GENERAL DENTIST)
(212) 740-2800
Entity
Organization
Contact information
Practice address
1569 SAINT NICHOLAS AVE, NEW YORK, NY 10040-4261
(212) 740-2800
(212) 740-1900
Mailing address
1569 SAINT NICHOLAS AVE, NEW YORK, NY 10040-4261
(212) 740-2800
(212) 740-1900
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
048089
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01926416
—
NY
Enumeration date
03/28/2008
Last updated
03/28/2008
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