Provider Demographics
NPI:1104404532
Name:MAGRO, MERCEDES ISABEL (DMD)
Entity type:Individual
Prefix:DR
First Name:MERCEDES
Middle Name:ISABEL
Last Name:MAGRO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4340 US ROUTE 9
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-4036
Mailing Address - Country:US
Mailing Address - Phone:201-679-6362
Mailing Address - Fax:
Practice Address - Street 1:8 ULSTER AVE
Practice Address - Street 2:
Practice Address - City:SAUGERTIES
Practice Address - State:NY
Practice Address - Zip Code:12477-1211
Practice Address - Country:US
Practice Address - Phone:201-679-6362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0629071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice