| Queens Dental Group | |
|
11148 157th St Jamaica NY 11433-3726 | |
| (703) 870-1415 | |
| Not Available |
| Full Name | Queens Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 11148 157th St, Jamaica, New York |
| Authorized Official Name and Position | Michael De Lorenzo (DENTIST) |
| Authorized Official Contact | 7038701415 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Queens Dental Group 11148 157th St Jamaica NY 11433-3726 Ph: (703) 870-1415 | Queens Dental Group 11148 157th St Jamaica NY 11433-3726 Ph: (703) 870-1415 |
| NPI Number | 1568866903 |
|---|---|
| Provider Enumeration Date | 10/14/2014 |
| Last Update Date | 10/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568866903 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 040975 (New York) | Primary |
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