Individual
AYOMIDE ADEOLA OSUNKOYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(888) 700-6623
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
36360
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/13/2019
Last updated
09/04/2020
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