| Pesantes Dental Pc | |
|
11109 Jamaica Ave Richmond Hill NY 11418-2323 | |
| (718) 850-1011 | |
| (718) 850-6086 |
| Full Name | Pesantes Dental Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11109 Jamaica Ave, Richmond Hill, New York |
| Authorized Official Name and Position | Juan J Pesantes (PRESIDENT) |
| Authorized Official Contact | 7188501011 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pesantes Dental Pc 11109 Jamaica Ave Richmond Hill NY 11418-2323 Ph: (718) 850-1011 | Pesantes Dental Pc 11109 Jamaica Ave Richmond Hill NY 11418-2323 Ph: (718) 850-1011 |
| NPI Number | 1245525351 |
|---|---|
| Provider Enumeration Date | 06/16/2011 |
| Last Update Date | 06/16/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245525351 | NPI | - | NPPES |
| 01738614 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 046461 (New York) | Primary |
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