Corona Dental Office, Pc | |
10807 Corona Ave 2 Floor Corona NY 11368-3941 | |
(718) 760-3417 | |
(718) 760-3417 |
Full Name | Corona Dental Office, Pc |
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Speciality | Dentist - General Practice |
Location | 10807 Corona Ave, Corona, New York |
Authorized Official Name and Position | Wascar Alexi Ramirez (OWNER) |
Authorized Official Contact | 7187603417 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Corona Dental Office, Pc 10807 Corona Ave 2 Floor Corona NY 11368-3941 Ph: (718) 760-3417 | Corona Dental Office, Pc 10807 Corona Ave 2 Floor Corona NY 11368-3941 Ph: (718) 760-3417 |
NPI Number | 1063797009 |
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Provider Enumeration Date | 10/20/2011 |
Last Update Date | 10/20/2011 |
Identifier | Type | State | Issuer |
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1063797009 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 0484861 (New York) | Primary |
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