Individual
MISS ELIZABETH SOPHIE PERSICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
15 E 91ST ST, NEW YORK, NY 10128-0648
(212) 966-6680
Mailing address
78 LAIGHT ST, NEW YORK, NY 10013-2016
(212) 966-6680
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
055145
NY
1223P0221X
Pediatric Dentistry
Primary
055145
NY
Other
Enumeration date
05/03/2009
Last updated
09/01/2020
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