Organization
ESSEX DENTAL OFFICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE RAFAEL DE LEON D.D.S. (PRESIDENT)
(212) 228-2999
Entity
Organization
Contact information
Practice address
143 ESSEX ST, NEW YORK, NY 10002-2336
(212) 228-2999
(212) 228-3323
Mailing address
143 ESSEX ST, NEW YORK, NY 10002-2336
(212) 228-2999
(212) 228-3323
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
046096
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02228504
—
NY
Enumeration date
05/21/2007
Last updated
01/25/2008
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