Individual
MARIA DEL MAR JORGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(800) 636-6683
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
(787) 376-9351
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
061847
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/14/2019
Last updated
07/05/2022
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