Modesto-Garrido, Mayra

Modesto-Garrido, Mayra is an individual health care provider with primary practice located at 266 Harristown Rd Suite 102, Glen Rock NJ 07452-3302. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Modesto-Garrido, Mayra can be contacted via phone (201) 652-0400.

Contact Information

Primary practice address
266 Harristown Rd Suite 102 Glen Rock NJ 07452-3302
Phone: (201) 652-0400
Fax: (201) 447-5762
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 22DI01825501 New Jersey

Profile Details

NPI number 1568524528
LBN Legal business name Modesto-Garrido, Mayra
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 2006
Last updated Mar 16th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568524528 NPPES
New Jersey MEDICAID 0066028
New Jersey MEDICAID 6037704
New Jersey Other 898217

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