| Aqua Dental Pc | |
|
1283 Arsenal St Watertown NY 13601-2252 | |
| (315) 788-7888 | |
| (315) 788-7833 |
| Full Name | Aqua Dental Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1283 Arsenal St, Watertown, New York |
| Authorized Official Name and Position | Rubina Khatoon (OWNER) |
| Authorized Official Contact | 3157887888 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aqua Dental Pc 1283 Arsenal St Watertown NY 13601-2252 Ph: (315) 788-7888 | Aqua Dental Pc 1283 Arsenal St Watertown NY 13601-2252 Ph: (315) 788-7888 |
| NPI Number | 1073785556 |
|---|---|
| Provider Enumeration Date | 03/25/2008 |
| Last Update Date | 03/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073785556 | NPI | - | NPPES |
| 02698960 | Medicaid | NY | |
| 1772007 | Other | NY | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 052355 (New York) | Primary |
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