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General NPI Number Information
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NPI Number | 1356477293
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Entity Type | Individual
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Provider Name | GERARDO YABLONOVICH DDS
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Gender | Male
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1559 49TH ST
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City | BROOKLYN
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State | NY
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Zip | 11219-3212
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Country | US
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Telephone | 718-436-7750
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Fax | 718-851-8557
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Provider Business Mailing Address
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Address Line | 404 JONES RD
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-5001
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Country | US
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Telephone | 201-569-2931
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 038296
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License Number State | NY
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