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3901 Main St Ste 211 Flushing NY 11354-5435 | |
| (718) 710-1893 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 3901 Main St Ste 211, Flushing, New York |
| Authorized Official Name and Position | Danielle L Sim (PRESIDENT) |
| Authorized Official Contact | 7187101893 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3901 Main St Ste 211 Flushing NY 11354-5435 Ph: (718) 710-1893 | 3901 Main St Ste 211 Flushing NY 11354-5435 Ph: (718) 710-1893 |
| NPI Number | 1356775316 |
|---|---|
| Provider Enumeration Date | 08/27/2013 |
| Last Update Date | 08/27/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356775316 | NPI | - | NPPES |
| 03161864 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 054654 (New York) | Primary |
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