Individual
MONA BOSIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
630 W 168TH ST PH 7, NEW YORK, NY 10032-3725
(212) 305-7069
Mailing address
12 GRANDVIEW AVE, STAMFORD, CT 06905-4803
(203) 278-4740
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
059419
NY
Other
Enumeration date
08/26/2017
Last updated
08/26/2017
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