| 5b105strdentalpc | |
|
5 Beach 105th St Rockaway Park NY 11694-2699 | |
| (718) 474-0007 | |
| (718) 474-0004 |
| Full Name | 5b105strdentalpc |
|---|---|
| Speciality | Dentist |
| Location | 5 Beach 105th St, Rockaway Park, New York |
| Authorized Official Name and Position | Joanna Kowalewski (DENTIST) |
| Authorized Official Contact | 7184740007 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 5b105strdentalpc 5 Beach 105th St Rockaway Park NY 11694-2699 Ph: (718) 474-0007 | 5b105strdentalpc 5 Beach 105th St Rockaway Park NY 11694-2699 Ph: (718) 474-0007 |
| NPI Number | 1306052618 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306052618 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 046206-1 (New York) | Primary |
Smile Masters Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11412 Beach Channel Dr Ste 4, Rockaway Park, NY 11694 Phone: 718-924-2091 | |
Rockaway Beach Orthodontics, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11412 Beach Channel Dr Ste 4, Rockaway Park, NY 11694 Phone: 718-924-2091 |