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DECENIA PIMENTEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
630 W 168TH ST, NEW YORK, NY 10032-3725
(212) 305-9904
Mailing address
P & S BOX 20, 630 WEST 168 STREET, NEW YORK, NY 10032
(212) 305-9904

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
22HI00940500
NJ
124Q00000X
Dental Hygienist
Primary
51 024640
NY

Other

Enumeration date
11/22/2016
Last updated
11/22/2016
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