| Skyline Dental | |
|
2807 Jackson Ave Long Island City NY 11101-3458 | |
| (917) 572-3637 | |
| Not Available |
| Full Name | Skyline Dental |
|---|---|
| Speciality | Dentist |
| Location | 2807 Jackson Ave, Long Island City, New York |
| Authorized Official Name and Position | Patricia Izquierdo (OWNER) |
| Authorized Official Contact | 9175723637 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Skyline Dental 2807 Jackson Ave Long Island City NY 11101-3458 Ph: () - | Skyline Dental 2807 Jackson Ave Long Island City NY 11101-3458 Ph: (917) 572-3637 |
| NPI Number | 1477261972 |
|---|---|
| Provider Enumeration Date | 11/14/2022 |
| Last Update Date | 11/23/2022 |
| Medicare PECOS PAC ID | 2668844309 |
|---|---|
| Medicare Enrollment ID | O20230207001172 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477261972 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Patricia M Izquierdo |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1972947349 PECOS PAC ID: 3577935212 Enrollment ID: I20230207001298 |
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