| S T Dental Service Pc | |
|
1908 Mott Ave Far Rockaway NY 11691-4101 | |
| (718) 327-8816 | |
| (718) 327-5197 |
| Full Name | S T Dental Service Pc |
|---|---|
| Speciality | Dentist |
| Location | 1908 Mott Ave, Far Rockaway, New York |
| Authorized Official Name and Position | Svetlana Terentieva (PRESIDENT) |
| Authorized Official Contact | 7183273816 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| S T Dental Service Pc 1908 Mott Ave Far Rockaway NY 11691-4101 Ph: (718) 327-8816 | S T Dental Service Pc 1908 Mott Ave Far Rockaway NY 11691-4101 Ph: (718) 327-8816 |
| NPI Number | 1679534119 |
|---|---|
| Provider Enumeration Date | 03/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679534119 | NPI | - | NPPES |
| 02110098 | Medicaid | NY | |
| 9176812 | Other | NY | DORAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 049077 (New York) | Primary |
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