Individual
MISS CAMILLE SUZETTE SAN MIGUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
8708 WOODHAVEN BLVD, WOODHAVEN, NY 11421-2284
(718) 805-7777
Mailing address
37 CATHERINE ST APT 5C, NEW YORK, NY 10038-1049
(240) 491-7171
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
061259
NY
Other
Enumeration date
02/01/2018
Last updated
07/13/2021
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