| Astoria Dental Broadway | |
|
31-72 31st St Suite #1 Astoria NY 11106 | |
| (929) 522-0554 | |
| Not Available |
| Full Name | Astoria Dental Broadway |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 31-72 31st St, Astoria, New York |
| Authorized Official Name and Position | Andrew Maron (OWNER) |
| Authorized Official Contact | 9295220554 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Astoria Dental Broadway 31-72 31st St Suite #1 Astoria NY 11106 Ph: (929) 522-0554 | Astoria Dental Broadway 31-72 31st St Suite #1 Astoria NY 11106 Ph: (929) 522-0554 |
| NPI Number | 1730675273 |
|---|---|
| Provider Enumeration Date | 07/09/2018 |
| Last Update Date | 07/09/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730675273 | NPI | - | NPPES |
| 1215035134 | Other | TYPE 2 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 043641 (New York) | Primary |
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