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Individual

DR. JACQUELINE MIKHLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-9877
Mailing address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(917) 974-8445

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
055982
NY
1223P0221X
Pediatric Dentistry
Primary
22DI02529300
NJ

Other

Enumeration date
06/25/2010
Last updated
01/28/2019
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