Organization · Type 2 NPI

Gudella S. Licaros, DDS

Dental Clinic/Center · New York, NY

NPI number 1376737288 Active

Practice location

155 W 68th St, Suite 226
New York, NY 10023-5808

Call (212) 787-2749 Map

Mailing address

155 West 68th Street, Suite 226
New York, NY 10023-5808

Specialties and licenses

TaxonomyCodeLicense
Dental Clinic/Center Primary 261QD0000X043676 (NY)

Dental Clinic/Center: Definition to come...

7 other providers at this address

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About NPI 1376737288

Gudella S. Licaros, DDS's National Provider Identifier is 1376737288, issued on Sep 4, 2007. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in New York, NY. The record was last updated on Sep 4, 2007.