| Creative Dental Of Queens | |
|
63-58 Wetherole Street Rego Park NY 11374 | |
| (718) 459-4700 | |
| (914) 390-9111 |
| Full Name | Creative Dental Of Queens |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 63-58 Wetherole Street, Rego Park, New York |
| Authorized Official Name and Position | Timur Mozner (DENTIST) |
| Authorized Official Contact | 7184594700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creative Dental Of Queens 63-58 Wetherole Street Rego Park NY 11374 Ph: (718) 459-4700 | Creative Dental Of Queens 63-58 Wetherole Street Rego Park NY 11374 Ph: (718) 459-4700 |
| NPI Number | 1871981068 |
|---|---|
| Provider Enumeration Date | 12/23/2014 |
| Last Update Date | 12/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871981068 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 048393 (New York) | Primary |
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