Individual
DR. MICHELE JACLYN EQUINDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
15 HARRISON ST, NEW YORK, NY 10013-2890
(212) 758-0040
Mailing address
15 HARRISON ST, NEW YORK, NY 10013-2890
(516) 672-3267
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
019.030585
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
059708
NY
Other
Enumeration date
06/01/2018
Last updated
03/04/2019
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