Individual
DR. JACQUELINE POLANCO
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
(718) 515-5419
Mailing address
231 W 230TH ST, APT #BGC, BRONX, NY 10463-5207
(718) 601-2448
(718) 515-5419
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
053120
NY
Other
Enumeration date
11/08/2006
Last updated
07/08/2007
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