Individual
DR. MAGNON IVAN REYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3753 91ST ST, JACKSON HEIGHTS, NY 11372-7901
(646) 306-7141
Mailing address
100 OLD PALISADE RD, APT 1102, FORT LEE, NJ 07024-7064
(646) 306-7141
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
053114
NY
Other
Enumeration date
10/12/2006
Last updated
04/01/2015
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