Individual
DR. MICHAEL CHARLES MISTRETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
200 CENTRAL PARK S, SUITE 105, NEW YORK, NY 10019-1436
(212) 245-3292
(212) 245-8758
Mailing address
200 CENTRAL PARK S, SUITE 105, NEW YORK, NY 10019-1436
(212) 245-3292
(212) 245-8758
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
049087-1
NY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
240428-1
NY
Other
Enumeration date
07/17/2006
Last updated
04/21/2025
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