| Organization Name: | GRAND DENTAL CARE PC |
| NPI Number: | 1053689463 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | FLORA ANGELA CHAVEZ-ROMERO (PRESIDENT) |
| Mailing Address: | 2000 Grand Ave North Baldwin |
| State: | NY US |
| Postal Code: | 115102811 |
| Phone Number: | 5163781968 |
| Fax Number: | 5166089319 |
| NPI Enumeration Date: | 12/13/2011 |
| NPI Last Update Date: | 03/22/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0700X |
| License Number: | 052129 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Prosthodontics |
| Taxonomy Definition: | That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |