Individual
DR. MARIA TERESA ATANACIO MANALAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
330 E 204TH ST, BRONX, NY 10467-4706
(718) 652-0290
Mailing address
345 E 81ST ST, APT 18G, NEW YORK, NY 10028-4005
(212) 426-0726
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
051461
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02587777
—
NY
Enumeration date
01/08/2007
Last updated
07/09/2007
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