| John N. Keriazes, D.d.s., P.c. | |
|
31-10 37 Avenue Suite 507 Long Island City NY 11101 | |
| (718) 728-3262 | |
| (718) 786-6823 |
| Full Name | John N. Keriazes, D.d.s., P.c. |
|---|---|
| Speciality | Dentist |
| Location | 31-10 37 Avenue, Long Island City, New York |
| Authorized Official Name and Position | John N Keriazes (OWNER) |
| Authorized Official Contact | 7187283262 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John N. Keriazes, D.d.s., P.c. 31-10 37 Avenue Suite 507 Long Island City NY 11101 Ph: (718) 728-3262 | John N. Keriazes, D.d.s., P.c. 31-10 37 Avenue Suite 507 Long Island City NY 11101 Ph: (718) 728-3262 |
| NPI Number | 1326301516 |
|---|---|
| Provider Enumeration Date | 06/21/2012 |
| Last Update Date | 06/21/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326301516 | NPI | - | NPPES |
| 02016475 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 0423571 (New York) | Primary |
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