Organization
IGDENTAL,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLGA M IGLESIAS DDS (DENTIST)
(212) 795-0765
Entity
Organization
Contact information
Practice address
4250 BROADWAY, SUITE 5 W, NEW YORK, NY 10033-3748
(212) 795-0765
(212) 795-3600
Mailing address
294 GREENBUSH RD, BLAUVELT, NY 10913-1933
(212) 795-0765
(212) 795-3600
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02561306
—
NY
Enumeration date
03/18/2008
Last updated
03/18/2008
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