Individual
CONSOLACION SOBERANO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
6710 ROCKAWAY BEACH BLVD, ARVERNE, NY 11692-1271
(718) 945-7150
(718) 327-8336
Mailing address
19 PEPPER CIR E, MASSAPEQUA, NY 11758-3509
(718) 945-7150
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
045753
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1223G0001X
DENTIST
NY
Enumeration date
07/29/2005
Last updated
07/08/2007
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