| Lil Pearls Pediatric Dentistry Pllc | |
|
94-11 65th Rd Suite 1b Rego Park NY 11374 | |
| (347) 682-5688 | |
| Not Available |
| Full Name | Lil Pearls Pediatric Dentistry Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 94-11 65th Rd, Rego Park, New York |
| Authorized Official Name and Position | Jeffrey Fong (MEMBER) |
| Authorized Official Contact | 5162419760 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lil Pearls Pediatric Dentistry Pllc 94-11 65th Rd Suite 1b Rego Park NY 11374 Ph: () - | Lil Pearls Pediatric Dentistry Pllc 94-11 65th Rd Suite 1b Rego Park NY 11374 Ph: (347) 682-5688 |
| NPI Number | 1669859294 |
|---|---|
| Provider Enumeration Date | 05/04/2015 |
| Last Update Date | 05/04/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669859294 | NPI | - | NPPES |
| 03634535 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 056689-1 (New York) | Primary |
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