| Juan Carlos Defex, Dds Pllc | |
|
7410 35th Ave Suite 106w Jackson Heights NY 11372-8197 | |
| (718) 476-6750 | |
| (718) 426-4040 |
| Full Name | Juan Carlos Defex, Dds Pllc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 7410 35th Ave, Jackson Heights, New York |
| Authorized Official Name and Position | Juan Carlos Defex (OWNER) |
| Authorized Official Contact | 7184766750 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Juan Carlos Defex, Dds Pllc 7410 35th Ave Suite 106w Jackson Heights NY 11372-8197 Ph: (718) 476-6750 | Juan Carlos Defex, Dds Pllc 7410 35th Ave Suite 106w Jackson Heights NY 11372-8197 Ph: (718) 476-6750 |
| NPI Number | 1437469459 |
|---|---|
| Provider Enumeration Date | 10/08/2010 |
| Last Update Date | 10/08/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437469459 | NPI | - | NPPES |
| 01407450 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 043060-1 (New York) | Primary |
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