Individual
GERALDINE SEVILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
155 E 38TH ST APT 2F, NEW YORK, NY 10016-2671
(212) 685-9243
(212) 972-0410
Mailing address
155 E 38TH STREET, APT. 2F, NEW YORK, NY 10016
(212) 685-9243
(212) 972-0410
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
057640
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/20/2014
Last updated
06/27/2017
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