Individual
DR. EDGAR GARY BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
81 IRVING PLACE, SUITE 1-D, NEW YORK, NY 10003-2257
(212) 260-2652
(212) 533-3331
Mailing address
81 IRVING PLACE,, SUITE 1-D, NEW YORK, NY 10003-2257
(212) 260-2652
(212) 533-3331
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
034002
NY
Other
Enumeration date
10/03/2012
Last updated
10/03/2012
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