Provider Demographics
NPI:1689863813
Name:TERRERO DENTAL, IV
Entity Type:Organization
Organization Name:TERRERO DENTAL, IV
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:EDUARDO
Authorized Official - Last Name:TERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-825-0943
Mailing Address - Street 1:17 BATTERY PL
Mailing Address - Street 2:SUITE 205
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-1207
Mailing Address - Country:US
Mailing Address - Phone:212-825-0943
Mailing Address - Fax:212-668-5252
Practice Address - Street 1:17 BATTERY PL
Practice Address - Street 2:SUITE 205
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-1207
Practice Address - Country:US
Practice Address - Phone:212-825-0943
Practice Address - Fax:212-668-5252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty