Organization
C.LEON VASQUEZ DENTAL SERVICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEON A VASQUEZ DDS (PRESIDENT)
(718) 507-9731
Entity
Organization
Contact information
Practice address
40-27 69TH ST, WOODSIDE, NY 11377-3836
(718) 507-9731
(718) 507-2700
Mailing address
40-27 69TH ST, WOODSIDE, NY 11377-3836
(718) 507-9731
(718) 507-2700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01283150
—
NY
05
—
01283169
—
NY
Enumeration date
04/02/2008
Last updated
04/02/2008
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