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NPI Code Detail

MEDICARE: TERRERO DENTAL II, PC

MEDICARE: TERRERO DENTAL II, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist043274NY

General Provider Information

NPI Number : 1275726275
Entity Type Code : Organization
Provider Name (Legal Business Name) : TERRERO DENTAL II, PC
Provider Business Mailing Address
First Line : 17 BATTERY PL STE 205
Second Line :
City : NEW YORK
State : NY
Zip : 10004-1151
Country : US
Telephone Number : 212-825-0943
Fax Number : 212-668-5252
Provider Business Practice Location Address
First Line : 7117 AUSTIN ST
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-4720
Country : US
Telephone Number : 718-268-4075
Fax Number : 718-268-4724
Authorized Official
Title or Position : PRESIDENT
Name : IVAN EDUARDO TERRERO
Credential :
Telephone Number : 212-825-0943
Provider Enumeration Date : 08/22/2007
Last Update Date : 08/22/2007

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