| Ccdi | |
|
3093 Brower Ave Oceanside NY 11572 | |
| (516) 678-8690 | |
| (516) 678-8692 |
| Full Name | Ccdi |
|---|---|
| Speciality | Dentist |
| Location | 3093 Brower Ave, Oceanside, New York |
| Authorized Official Name and Position | Mine E Calderon (DENTIST PRESIDENT) |
| Authorized Official Contact | 5166788690 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ccdi 3093 Brower Ave Oceanside NY 11572 Ph: (516) 678-8690 | Ccdi 3093 Brower Ave Oceanside NY 11572 Ph: (516) 678-8690 |
| NPI Number | 1780806638 |
|---|---|
| Provider Enumeration Date | 05/02/2007 |
| Last Update Date | 05/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780806638 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 045794 (New York) | Secondary |
| 122300000X | Dentist | 041073 (New York) | Primary |
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