| Radiant Smile Dental Care Pc | |
|
812 Jericho Tpke New Hyde Park NY 11040-4514 | |
| (516) 355-9510 | |
| (516) 437-4567 |
| Full Name | Radiant Smile Dental Care Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 812 Jericho Tpke, New Hyde Park, New York |
| Authorized Official Name and Position | Pavel Krastev (OWNER/PRESIDENT) |
| Authorized Official Contact | 5163559510 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Radiant Smile Dental Care Pc 812 Jericho Tpke New Hyde Park NY 11040-4514 Ph: (516) 355-9510 | Radiant Smile Dental Care Pc 812 Jericho Tpke New Hyde Park NY 11040-4514 Ph: (516) 355-9510 |
| NPI Number | 1043580038 |
|---|---|
| Provider Enumeration Date | 01/06/2012 |
| Last Update Date | 01/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043580038 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 044978 (New York) | Primary |
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