Provider Demographics
NPI:1275726275
Name:TERRERO DENTAL II, PC
Entity Type:Organization
Organization Name:TERRERO DENTAL II, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:EDUARDO
Authorized Official - Last Name:TERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-825-0943
Mailing Address - Street 1:17 BATTERY PL STE 205
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-1151
Mailing Address - Country:US
Mailing Address - Phone:212-825-0943
Mailing Address - Fax:212-668-5252
Practice Address - Street 1:7117 AUSTIN ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4720
Practice Address - Country:US
Practice Address - Phone:718-268-4075
Practice Address - Fax:718-268-4724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043274122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty