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Organization
STATEN ISLAND DENTAL BOUTIQUE
Active
Organization
STATEN ISLAND DENTAL BOUTIQUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLENA RONAN DDS (OWNER)
(347) 596-7719
Entity
Organization
Contact information
Practice address
1735 RICHMOND AVE FL 2, STATEN ISLAND, NY 10314-3907
(347) 596-7719
Mailing address
81 NARROWS RD N APT D, STATEN ISLAND, NY 10305-2818
(347) 596-7719
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
12/16/2022
Last updated
12/16/2022
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