Provider Demographics
NPI:1609896620
Name:PALAGANAS, CELIA (DDS)
Entity Type:Individual
Prefix:MRS
First Name:CELIA
Middle Name:
Last Name:PALAGANAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4804 207TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-1113
Mailing Address - Country:US
Mailing Address - Phone:718-225-7874
Mailing Address - Fax:718-225-3062
Practice Address - Street 1:4804 207TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-1113
Practice Address - Country:US
Practice Address - Phone:718-225-7874
Practice Address - Fax:718-225-3062
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044212-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02608139Medicaid