Provider Demographics
NPI:1952674780
Name:PILLA, DEBORAH (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:
Last Name:PILLA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:PILLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:870 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-1806
Mailing Address - Country:US
Mailing Address - Phone:212-879-6518
Mailing Address - Fax:212-879-6578
Practice Address - Street 1:870 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1806
Practice Address - Country:US
Practice Address - Phone:212-879-6518
Practice Address - Fax:212-879-6578
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0359261223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry