| Queens Modern Dental | |
|
21820 Hempstead Ave Suite 2 Queens Village NY 11429-1235 | |
| (718) 217-8700 | |
| (718) 217-8706 |
| Full Name | Queens Modern Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 21820 Hempstead Ave, Queens Village, New York |
| Authorized Official Name and Position | Lourdes Joanne Saint Paul (GENERAL DENTIST) |
| Authorized Official Contact | 7182178700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Queens Modern Dental 21820 Hempstead Ave Suite 2 Queens Village NY 11429-1235 Ph: (718) 217-8700 | Queens Modern Dental 21820 Hempstead Ave Suite 2 Queens Village NY 11429-1235 Ph: (718) 217-8700 |
| NPI Number | 1083991822 |
|---|---|
| Provider Enumeration Date | 11/08/2011 |
| Last Update Date | 11/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083991822 | NPI | - | NPPES |
| 02584774 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 050925 (New York) | Primary |
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Blaise Guzzardo Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 94-71 217th St, Queens Village, NY 11428 Phone: 718-464-4442 Fax: 718-464-4509 | |
Circe Lassegue Dds, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 21820 Hempstead Ave, Queens Village, NY 11429 Phone: 305-793-9219 |