Healthcare Provider Details

I. General information

NPI: 1962530600
Provider Name (Legal Business Name): MARIA MARGARITA ESPINOSA-DOVALE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 03/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 BROADWAY
WEST NEW YORK NJ
07093-2622
US

IV. Provider business mailing address

81 MAGNOLIA ST
ELMWOOD PARK NJ
07407-3029
US

V. Phone/Fax

Practice location:
  • Phone: 201-866-9320
  • Fax:
Mailing address:
  • Phone: 201-796-7292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22D102270400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: