| Hq Dental Pc | |
|
11620 Queens Blvd Forest Hills NY 11375-7055 | |
| (347) 283-2396 | |
| Not Available |
| Full Name | Hq Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 11620 Queens Blvd, Forest Hills, New York |
| Authorized Official Name and Position | Rafael Boruchov (OWNER) |
| Authorized Official Contact | 3472832396 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hq Dental Pc 11620 Queens Blvd Forest Hills NY 11375-7055 Ph: (347) 283-2396 | Hq Dental Pc 11620 Queens Blvd Forest Hills NY 11375-7055 Ph: (347) 283-2396 |
| NPI Number | 1437571395 |
|---|---|
| Provider Enumeration Date | 01/13/2014 |
| Last Update Date | 01/13/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437571395 | NPI | - | NPPES |
| 03718852 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 056907 (New York) | Primary |
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