| C.leon Vasquez Dental Service Pc | |
|
40-27 69th St Woodside NY 11377-3836 | |
| (718) 507-9731 | |
| (718) 507-2700 |
| Full Name | C.leon Vasquez Dental Service Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 40-27 69th St, Woodside, New York |
| Authorized Official Name and Position | Leon A Vasquez (PRESIDENT) |
| Authorized Official Contact | 7185079731 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| C.leon Vasquez Dental Service Pc 40-27 69th St Woodside NY 11377-3836 Ph: (718) 507-9731 | C.leon Vasquez Dental Service Pc 40-27 69th St Woodside NY 11377-3836 Ph: (718) 507-9731 |
| NPI Number | 1962674697 |
|---|---|
| Provider Enumeration Date | 04/02/2008 |
| Last Update Date | 04/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962674697 | NPI | - | NPPES |
| 01283150 | Medicaid | NY | |
| 01283169 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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