Organization
CLINICA DENTAL LATINA
Active
Other names
Hanette gomez dds
Organization subpart
No
Provider details
NPI number
Authorized official
JULIO ISIDOR (OFFICE MANAGER)
(718) 651-7070
Entity
Organization
Contact information
Practice address
9605 40TH RD, CORONA, NY 11368-2138
(718) 651-7070
(718) 651-6559
Mailing address
9605 40TH RD, CORONA, NY 11368-2138
(718) 651-7070
(718) 651-6559
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0438631
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01281218
—
NY
Enumeration date
01/24/2012
Last updated
01/24/2012
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