| Bellerose Dental P.c. | |
|
102-32 Jamaica Avenue Queens NY 11418 | |
| (718) 575-1889 | |
| Not Available |
| Full Name | Bellerose Dental P.c. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 102-32 Jamaica Avenue, Queens, New York |
| Authorized Official Name and Position | Iosif Uvaydov (OWNER) |
| Authorized Official Contact | 7185751889 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bellerose Dental P.c. 72-36 112th Street Apt.612 Forest Hills NY 11375 Ph: (718) 575-1889 | Bellerose Dental P.c. 102-32 Jamaica Avenue Queens NY 11418 Ph: (718) 575-1889 |
| NPI Number | 1336498070 |
|---|---|
| Provider Enumeration Date | 09/07/2012 |
| Last Update Date | 09/07/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336498070 | NPI | - | NPPES |
| 02585808 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 044283 (New York) | Primary |
Georgina Lopez Dentist P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3757 92 St, Queens, NY 11372 Phone: 718-672-6656 Fax: 718-672-6656 |