| Black Hall Dental, P.c. | |
|
10 Medical Plz Ste 210 Glen Cove NY 11542-2101 | |
| (516) 671-2903 | |
| Not Available |
| Full Name | Black Hall Dental, P.c. |
|---|---|
| Speciality | Dentist |
| Location | 10 Medical Plz Ste 210, Glen Cove, New York |
| Authorized Official Name and Position | Theresa Fan (ADMINISTRATOR) |
| Authorized Official Contact | 5166747646 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Black Hall Dental, P.c. 10 Medical Plz Ste 210 Glen Cove NY 11542-2101 Ph: (516) 671-2903 | Black Hall Dental, P.c. 10 Medical Plz Ste 210 Glen Cove NY 11542-2101 Ph: (516) 671-2903 |
| NPI Number | 1306698840 |
|---|---|
| Provider Enumeration Date | 04/05/2024 |
| Last Update Date | 04/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306698840 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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