| Kids Dental, P.c. | |
|
739 Woodraw Road Staten Island NY 10312 | |
| (718) 356-5437 | |
| (718) 356-5433 |
| Full Name | Kids Dental, P.c. |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 739 Woodraw Road, Staten Island, New York |
| Authorized Official Name and Position | Lisa Alli-lazzara (OWNER/PRESIDENT) |
| Authorized Official Contact | 9175825042 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kids Dental, P.c. 739 Woodraw Road Staten Island NY 10312 Ph: (718) 356-5437 | Kids Dental, P.c. 739 Woodraw Road Staten Island NY 10312 Ph: (718) 356-5437 |
| NPI Number | 1376803924 |
|---|---|
| Provider Enumeration Date | 05/16/2012 |
| Last Update Date | 06/20/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376803924 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 046975 (New York) | Primary |
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