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General NPI Number Information
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NPI Number | 1871769604
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Entity Type | Organization
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Legal Business Name | HUGHESCOLONDENTISTRYPC
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Dates
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Enumeration Date | 05/01/2008
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Last Update Date | 05/01/2008
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Provider Practice Location Address
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Address Line | 581 ACADEMY ST SUITE C
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City | NEW YORK
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State | NY
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Zip | 10034-5102
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Country | US
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Telephone | 212-942-1945
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Fax | 212-942-2498
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Provider Business Mailing Address
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Address Line | 581 ACADEMY ST OFC C
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City | NEW YORK
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State | NY
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Zip | 10034-5102
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Country | US
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Telephone | 212-942-1945
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Fax | 212-942-2498
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Authorized Official
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Title or Position | MANIGER
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Name | MR. SIXTO GUILLERMO TIGRERO
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Credential |
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Telephone | 212-942-1945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 043262
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License Number State | NY
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