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Individual

BRAYAN MOREJON VIDAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5700 BERGENLINE AVE STE 2, WEST NEW YORK, NJ 07093-1254
(551) 373-6260
Mailing address
345 E 24TH ST, NEW YORK, NY 10010-4020
(212) 998-9800

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI03100800
NJ
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/30/2023
Last updated
07/24/2025
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