Queens Smile Dental P.c. | |
98-76 Queens Blvd # 1 E Rego Park NY 11374-4300 | |
(718) 459-0591 | |
(718) 275-1355 |
Full Name | Queens Smile Dental P.c. |
---|---|
Speciality | Dentist |
Location | 98-76 Queens Blvd, Rego Park, New York |
Authorized Official Name and Position | Olga Zavulunova (OWNER) |
Authorized Official Contact | 7184590591 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Queens Smile Dental P.c. 98-76 Queens Blvd # 1 E Rego Park NY 11374-4300 Ph: (718) 459-0591 | Queens Smile Dental P.c. 98-76 Queens Blvd # 1 E Rego Park NY 11374-4300 Ph: (718) 459-0591 |
NPI Number | 1417135211 |
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Provider Enumeration Date | 02/04/2008 |
Last Update Date | 02/04/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1417135211 | NPI | - | NPPES |
01778936 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 047357 (New York) | Primary |
1223G0001X | Dentist - General Practice | 047357 (New York) | Secondary |
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