Individual
DR. CONSUELO TRINIDAD POVEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3721 75TH ST, JACKSON HEIGHTS, NY 11372-6405
(718) 476-3800
(718) 533-7808
Mailing address
3742 90TH ST, JACKSON HEIGHTS, NY 11372-7830
(718) 424-5559
(718) 426-2428
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
045030-1
NY
Other
Enumeration date
09/20/2006
Last updated
10/14/2020
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