| Superior Dental | |
|
2475 Grand Concourse Bronx NY 10468-5443 | |
| (718) 329-2929 | |
| (718) 329-2930 |
| Full Name | Superior Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2475 Grand Concourse, Bronx, New York |
| Authorized Official Name and Position | Svetlana Ponomareva (OWNER) |
| Authorized Official Contact | 7183292929 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Superior Dental 2475 Grand Concourse Bronx NY 10468-5443 Ph: (718) 329-2929 | Superior Dental 2475 Grand Concourse Bronx NY 10468-5443 Ph: (718) 329-2929 |
| NPI Number | 1275771248 |
|---|---|
| Provider Enumeration Date | 01/29/2009 |
| Last Update Date | 01/29/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275771248 | NPI | - | NPPES |
| 02224179 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 049663 (New York) | Primary |
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