Organization
FREEPORT DENTAL , PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE RAFAEL DE LEON D.D.S. (PRESIDENT)
(516) 665-8931
Entity
Organization
Contact information
Practice address
117 W SUNRISE HWY, FREEPORT, NY 11520-3614
(516) 665-8931
(516) 665-8933
Mailing address
117 W SUNRISE HWY, FREEPORT, NY 11520-3614
(516) 665-8931
(516) 665-8933
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
046096
NY
Other
Enumeration date
03/31/2008
Last updated
03/31/2008
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