Individual
JOAN SO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4350 HYLAN BLVD, STATEN ISLAND, NY 10312
(718) 317-7211
Mailing address
1379 HUGUENOT AVE, STATEN ISLAND, NY 10312
(646) 226-9750
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0414461
NY
Other
Enumeration date
11/20/2006
Last updated
07/08/2007
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