Individual
MRS. PATRICIA I JUAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
8 MEDICAL DR, PORT JEFFERSON STATION, NY 11776
(631) 928-8585
(631) 928-8861
Mailing address
2 CAMEO RD, COMMACK, NY 11725-2017
(631) 462-1818
(631) 462-1818
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
049452
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02428339
—
NY
Enumeration date
02/05/2007
Last updated
07/08/2007
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