| Banana Smiles Pediatric Dentistry Pllc | |
|
5611 94th St Ste Ln Elmhurst NY 11373-5004 | |
| (718) 760-8700 | |
| Not Available |
| Full Name | Banana Smiles Pediatric Dentistry Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 5611 94th St Ste Ln, Elmhurst, New York |
| Authorized Official Name and Position | Fawaz Shihadeh (PEDIATRIC DENTIST/ OWNER) |
| Authorized Official Contact | 5617168623 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Banana Smiles Pediatric Dentistry Pllc 11 Herkimer St Apt 2a Brooklyn NY 11216-6582 Ph: (561) 716-8623 | Banana Smiles Pediatric Dentistry Pllc 5611 94th St Ste Ln Elmhurst NY 11373-5004 Ph: (718) 760-8700 |
| NPI Number | 1447947924 |
|---|---|
| Provider Enumeration Date | 04/24/2023 |
| Last Update Date | 04/24/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447947924 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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