Organization
JUAN COLLADO, DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUAN PABLO COLLADO D.D.S. (PRESIDENT)
(212) 568-3231
Entity
Organization
Contact information
Practice address
520 W 190TH ST, SUITE A, NEW YORK, NY 10040-3407
(212) 568-3231
(212) 568-7727
Mailing address
365 ROCKLEDGE PL, PRIVATE HOUSE, TEANECK, NJ 07666-4014
(212) 568-3231
(212) 568-7727
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
045828-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02752707
—
NY
Enumeration date
05/14/2007
Last updated
08/22/2020
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