Provider Demographics
NPI:1871758623
Name:SERVIO J. TUERO, D.D.S., PLLC
Entity type:Organization
Organization Name:SERVIO J. TUERO, D.D.S., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SERVIO
Authorized Official - Middle Name:J
Authorized Official - Last Name:TUERO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-362-3993
Mailing Address - Street 1:115 CENTRAL PARK W
Mailing Address - Street 2:SUITE 8
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-4198
Mailing Address - Country:US
Mailing Address - Phone:212-362-3993
Mailing Address - Fax:
Practice Address - Street 1:115 CENTRAL PARK W
Practice Address - Street 2:SUITE 8
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-4198
Practice Address - Country:US
Practice Address - Phone:212-362-3993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0379621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty