| Mavis Ng Dmd Comprehensive Dentistry Pllc | |
|
840 Hanshaw Rd Ste 14 Ithaca NY 14850-1589 | |
| (607) 257-2322 | |
| Not Available |
| Full Name | Mavis Ng Dmd Comprehensive Dentistry Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 840 Hanshaw Rd Ste 14, Ithaca, New York |
| Authorized Official Name and Position | Mavis Ng (DOCTOR) |
| Authorized Official Contact | 6042572322 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mavis Ng Dmd Comprehensive Dentistry Pllc 840 Hanshaw Rd Ste 14 Ithaca NY 14850-1589 Ph: (607) 257-2322 | Mavis Ng Dmd Comprehensive Dentistry Pllc 840 Hanshaw Rd Ste 14 Ithaca NY 14850-1589 Ph: (607) 257-2322 |
| NPI Number | 1588356257 |
|---|---|
| Provider Enumeration Date | 05/22/2023 |
| Last Update Date | 06/07/2023 |
| Medicare PECOS PAC ID | 5698132579 |
|---|---|
| Medicare Enrollment ID | O20230608000744 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588356257 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Mavis Ng |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1952415259 PECOS PAC ID: 6507223484 Enrollment ID: I20230608000881 |
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