Individual
DR. LILIANA SOFIA AGUDELO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
528 3RD AVENUE, BROOKLYN, NY 11215
(718) 965-4549
Mailing address
78 MORRISON AVENUE, STATEN ISLAND, NY 10310
(718) 727-4770
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
043387
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01238619
—
NY
Enumeration date
10/02/2007
Last updated
10/02/2007
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