Individual
DR. JUAN PABLO COLLADO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
520 W 190TH ST, SUITE A, NEW YORK, NY 10040-3407
(212) 568-3231
(212) 568-7727
Mailing address
520 W 190TH ST, SUITE A, NEW YORK, NY 10040-3407
(212) 568-3231
(212) 568-7727
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
045828
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01539651
—
NY
Enumeration date
10/20/2005
Last updated
07/08/2007
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