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Provider Information for 1497892657



DR. MARGARITA DEGTYAREVA DDS

Gender: FEMALE

Individual NPI: 1497892657

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1497892657
Enumeration Date 2007-01-30
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 1725 SHEEPSHEAD BAY RD
BROOKLYN, NY 11235-3606
United States

Phone: 718-743-0299 | Fax: 718-743-1468
View Map External Link
Primary Practice Address 1725 SHEEPSHEAD BAY RD
BROOKLYN, NY 11235-3606
United States

Phone: 718-743-0299 | Fax: 718-743-1468
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice NY 050331