Organization
LJ PROFESSIONAL DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LIBIA REBECA JIMENEZ (DDS)
(212) 368-9532
Entity
Organization
Contact information
Practice address
600 W 146TH ST, NEW YORK, NY 10031-4301
(212) 368-9532
(212) 368-2245
Mailing address
600 W 146TH ST, NEW YORK, NY 10031-4301
(212) 368-9532
(212) 368-2245
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
045307
NY
Other
Enumeration date
05/07/2007
Last updated
08/29/2007
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