Individual
NAZLI DIBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5121 108TH ST, CORONA, NY 11368-3304
(718) 699-9500
(718) 699-9021
Mailing address
27 BAKER HILL RD, GREAT NECK, NY 11023-1435
(516) 570-2937
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
050363-1
NY
Other
Enumeration date
02/02/2009
Last updated
02/02/2009
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