| Advanced Dentistry Dental Office Pc | |
|
3051 Ocean Ave Suite A10 Brooklyn NY 11235 | |
| (718) 934-9494 | |
| (718) 891-6439 |
| Full Name | Advanced Dentistry Dental Office Pc |
|---|---|
| Speciality | Dentist |
| Location | 3051 Ocean Ave, Brooklyn, New York |
| Authorized Official Name and Position | Tamara Likholetova (PRESIDENT) |
| Authorized Official Contact | 7189349494 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Dentistry Dental Office Pc 3051 Ocean Ave Suite A10 Brooklyn NY 11235 Ph: (718) 934-9494 | Advanced Dentistry Dental Office Pc 3051 Ocean Ave Suite A10 Brooklyn NY 11235 Ph: (718) 934-9494 |
| NPI Number | 1447478318 |
|---|---|
| Provider Enumeration Date | 04/23/2007 |
| Last Update Date | 08/03/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447478318 | NPI | - | NPPES |
| 01688646 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 0467811 (New York) | Primary |
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