| Great Neck Laser Dental | |
|
3651 Bell Blvd Bayside NY 11361-2169 | |
| (718) 279-8588 | |
| (718) 631-6784 |
| Full Name | Great Neck Laser Dental |
|---|---|
| Speciality | Clinic/Center |
| Location | 3651 Bell Blvd, Bayside, New York |
| Authorized Official Name and Position | Hyang-rim Lee (PRESIDENT) |
| Authorized Official Contact | 7182798588 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Neck Laser Dental 3651 Bell Blvd Bayside NY 11361-2169 Ph: (718) 279-8588 | Great Neck Laser Dental 3651 Bell Blvd Bayside NY 11361-2169 Ph: (718) 279-8588 |
| NPI Number | 1598533903 |
|---|---|
| Provider Enumeration Date | 12/14/2023 |
| Last Update Date | 04/02/2024 |
| Medicare PECOS PAC ID | 5890135628 |
|---|---|
| Medicare Enrollment ID | O20240426002797 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598533903 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Hyang-rim Lee |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1447313481 PECOS PAC ID: 7517307341 Enrollment ID: I20240426003032 |
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