| Pm Dental Services Pc | |
|
9045 Pitkin Ave Ozone Park NY 11417-2706 | |
| (718) 843-7551 | |
| Not Available |
| Full Name | Pm Dental Services Pc |
|---|---|
| Speciality | Dentist |
| Location | 9045 Pitkin Ave, Ozone Park, New York |
| Authorized Official Name and Position | Paul Hennis (DENTIST) |
| Authorized Official Contact | 6317486136 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pm Dental Services Pc 299 Candlewood Path Dix Hills NY 11746-8003 Ph: (631) 748-6136 | Pm Dental Services Pc 9045 Pitkin Ave Ozone Park NY 11417-2706 Ph: (718) 843-7551 |
| NPI Number | 1861664864 |
|---|---|
| Provider Enumeration Date | 03/31/2008 |
| Last Update Date | 03/31/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861664864 | NPI | - | NPPES |
| 01109815 | Medicaid | NY | |
| 00739359 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 037149 (New York) | Primary |
| 122300000X | Dentist | 041974 (New York) | Secondary |
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