| Dr. I Dental Pc | |
|
8610 Grand Ave 1b Elmhurst NY 11373 | |
| (631) 517-8166 | |
| (631) 517-8166 |
| Full Name | Dr. I Dental Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 8610 Grand Ave, Elmhurst, New York |
| Authorized Official Name and Position | Emmanuil Ilyayev (DENTIST) |
| Authorized Official Contact | 6315178166 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. I Dental Pc 8610 Grand Ave 1b Elmhurst NY 11373 Ph: (631) 517-8166 | Dr. I Dental Pc 8610 Grand Ave 1b Elmhurst NY 11373 Ph: (631) 517-8166 |
| NPI Number | 1053819318 |
|---|---|
| Provider Enumeration Date | 01/31/2018 |
| Last Update Date | 01/31/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053819318 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 058141 (New York) | Primary |
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