DR. Jose Agustin Ravelo, DDS

NPI #1487601613 in West New York, New Jersey

Provider Information

NPI Number: 1487601613
Entity Type: Individual
Name: DR. Jose Agustin Ravelo, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: May 31, 2006
Last Updated: Jul 26, 2019

Practice Location

Address: 5620 BERGENLINE AVE STE 2
City: West New York
State: New Jersey
ZIP Code: 07093-1257
Phone: (201) 861-9400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X
Dentist - General Practice — General Practice	1223G0001X	Primary

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