| Astoria Dental Group Pc | |
|
3217 Broadway Astoria NY 11106-2674 | |
| (718) 278-1123 | |
| (718) 278-6048 |
| Full Name | Astoria Dental Group Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3217 Broadway, Astoria, New York |
| Authorized Official Name and Position | Clifford Edward Degel (PRESIDENT) |
| Authorized Official Contact | 7182781123 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Astoria Dental Group Pc 3217 Broadway Astoria NY 11106-2674 Ph: (718) 278-1123 | Astoria Dental Group Pc 3217 Broadway Astoria NY 11106-2674 Ph: (718) 278-1123 |
| NPI Number | 1548484322 |
|---|---|
| Provider Enumeration Date | 04/12/2007 |
| Last Update Date | 02/03/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548484322 | NPI | - | NPPES |
| 01227738 | Medicaid | NY | |
| 01215461 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 042417 (New York) | Primary |
| 1223G0001X | Dentist - General Practice | 043236 (New York) | Secondary |
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