Juan Carlos Portela, DMD

NPI #1952599649 in Glendale, New York

Provider Information

NPI Number: 1952599649
Entity Type: Individual
Name: Juan Carlos Portela, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DMD
Enumeration Date: Oct 9, 2007
Last Updated: Feb 16, 2016

Practice Location

Address: 6222 MYRTLE AVE
City: Glendale
State: New York
ZIP Code: 11385-6236
Phone: (718) 821-7432

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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