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SURMILENA POLANCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
183 JEFFERSON ST, 2ND FLOOR, PASSAIC, NJ 07055
(973) 472-1010
(973) 473-6232
Mailing address
183 JEFFERSON ST, 2ND FLOOR, PASSAIC, NJ 07055
(973) 472-1010
(973) 473-6232

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22D102282700
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0077933
NJ
Enumeration date
01/30/2007
Last updated
06/05/2008
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