| Medidental Group Llc | |
|
2246 31st St Astoria NY 11105-2786 | |
| (347) 283-2396 | |
| Not Available |
| Full Name | Medidental Group Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2246 31st St, Astoria, New York |
| Authorized Official Name and Position | Emanuel Inoyatov (CEO) |
| Authorized Official Contact | 3472832396 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medidental Group Llc 2246 31st St Astoria NY 11105-2786 Ph: (347) 283-2396 | Medidental Group Llc 2246 31st St Astoria NY 11105-2786 Ph: (347) 283-2396 |
| NPI Number | 1518439967 |
|---|---|
| Provider Enumeration Date | 12/26/2018 |
| Last Update Date | 12/26/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518439967 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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