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General NPI Number Information
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NPI Number | 1417189853
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Entity Type | Individual
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Provider Name | CAMILLE CHIQUES DMD
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Gender | Female
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Dates
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Enumeration Date | 08/19/2009
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Last Update Date | 05/10/2017
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Provider Practice Location Address
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Address Line | 447 E 78TH ST APT 2B
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City | NEW YORK
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State | NY
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Zip | 10075-1652
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Country | US
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Telephone | 787-370-8875
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Fax |
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Provider Business Mailing Address
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Address Line | 447 E 78TH ST APT 2B
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City | NEW YORK
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State | NY
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Zip | 10075-1652
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Country | US
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Telephone | 787-370-8875
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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 | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | 001176
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 054601
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License Number State | NY
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