| Hughescolondentistrypc | |
|
581 Academy St Suite C New York NY 10034-5102 | |
| (212) 942-1945 | |
| (212) 942-2498 |
| Full Name | Hughescolondentistrypc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 581 Academy St Suite C, New York, New York |
| Authorized Official Name and Position | Sixto Guillermo Tigrero (MANIGER) |
| Authorized Official Contact | 2129421945 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hughescolondentistrypc 581 Academy St Ofc C New York NY 10034-5102 Ph: (212) 942-1945 | Hughescolondentistrypc 581 Academy St Suite C New York NY 10034-5102 Ph: (212) 942-1945 |
| NPI Number | 1871769604 |
|---|---|
| Provider Enumeration Date | 05/01/2008 |
| Last Update Date | 05/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871769604 | NPI | - | NPPES |
| 01278335 | Medicaid | NY | |
| 1467517979 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 043262 (New York) | Primary |
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