| Rsn Dental Pc | |
|
3589 Richmond Ave 1st Floor Staten Island NY 10312-3410 | |
| (718) 317-1737 | |
| (718) 317-1739 |
| Full Name | Rsn Dental Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3589 Richmond Ave, Staten Island, New York |
| Authorized Official Name and Position | Vladislav Shikhmanter (PRACTITIONER/PRESIDENT) |
| Authorized Official Contact | 7183171737 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rsn Dental Pc 3589 Richmond Ave 1st Floor Staten Island NY 10312-3410 Ph: (718) 317-1737 | Rsn Dental Pc 3589 Richmond Ave 1st Floor Staten Island NY 10312-3410 Ph: (718) 317-1737 |
| NPI Number | 1285741140 |
|---|---|
| Provider Enumeration Date | 08/24/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285741140 | NPI | - | NPPES |
| 01978954 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 048325 (New York) | Primary |
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