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Individual

DR. EDWIN OSTIAGO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
8215 ROOSEVELT AVE FL 2, JACKSON HEIGHTS, NY 11372-7034
(718) 205-7709
Mailing address
8215 ROOSEVELT AVE FL 2, JACKSON HEIGHTS, NY 11372-7034
(718) 205-7709

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
051025
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02473518
NY
Enumeration date
05/08/2007
Last updated
07/08/2007
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