Individual
JACQUELINE DIKANSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
201 E 21ST ST APT 1H, NEW YORK, NY 10010-6401
(000) 000-0000
Mailing address
201 E 21ST ST APT 1H, NEW YORK, NY 10010-6401
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
059414-01
NY
Other
Enumeration date
04/21/2015
Last updated
07/27/2022
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