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Provider Information for 1497892657



DR. MARGARITA DEGTYAREVA DDS

Gender: FEMALE

Individual NPI: 1497892657

Calendar Last Updated: 2007-07-08

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
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice NY 050331
Other Identifiers
Issuer State Number
Endpoint Information
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location