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Individual

DANIEL SIERRA-VASQUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
798 CONNETQUOT AVE, ISLIP TERRACE, NY 11752-1804
(631) 338-4983
Mailing address
798 CONNETQUOT AVE, ISLIP TERRACE, NY 11752-1804

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS041613
PA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/17/2017
Last updated
03/28/2019
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