Provider Demographics
NPI:1871259614
Name:CAMILO ACHURY DDS PC
Entity type:Organization
Organization Name:CAMILO ACHURY DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CAMILO
Authorized Official - Middle Name:DARIO
Authorized Official - Last Name:ACHURY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-335-1331
Mailing Address - Street 1:3545 79TH ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-4818
Mailing Address - Country:US
Mailing Address - Phone:718-335-1331
Mailing Address - Fax:716-396-2593
Practice Address - Street 1:3545 79TH ST BSMT
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-4818
Practice Address - Country:US
Practice Address - Phone:718-335-1331
Practice Address - Fax:718-396-2593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental