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Organization
MANHATTAN PARK DENTAL, PLLC
Active
Organization
MANHATTAN PARK DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAMILLE SUZETTE SAN MIGUEL DDS (PRESIDENT)
(240) 491-7171
Entity
Organization
Contact information
Practice address
30 CENTRAL PARK S RM 11C, NEW YORK, NY 10019-1628
(212) 702-8675
(212) 702-8675
Mailing address
30 CENTRAL PARK S RM 11C, NEW YORK, NY 10019-1628
(212) 702-8675
(212) 702-8675
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0700X
Prosthodontics
—
—
Other
Enumeration date
03/17/2025
Last updated
03/28/2025
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