| Mohammed Shahabuddin Dental P.c. | |
|
3004 36th Ave Long Island City NY 11106-2315 | |
| (718) 361-8677 | |
| (718) 361-0278 |
| Full Name | Mohammed Shahabuddin Dental P.c. |
|---|---|
| Speciality | Dentist |
| Location | 3004 36th Ave, Long Island City, New York |
| Authorized Official Name and Position | Mohammed Shahabuddin (OWNER) |
| Authorized Official Contact | 7183618677 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mohammed Shahabuddin Dental P.c. 3004 36th Ave Long Island City NY 11106-2315 Ph: (718) 361-8677 | Mohammed Shahabuddin Dental P.c. 3004 36th Ave Long Island City NY 11106-2315 Ph: (718) 361-8677 |
| NPI Number | 1982880159 |
|---|---|
| Provider Enumeration Date | 01/17/2008 |
| Last Update Date | 04/26/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982880159 | NPI | - | NPPES |
| 01172485 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 042617 (New York) | Primary |
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