| Upper Ditmars Dental Pllc | |
|
2128 80th St East Elmhurst NY 11370-1323 | |
| (908) 705-7122 | |
| Not Available |
| Full Name | Upper Ditmars Dental Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2128 80th St, East Elmhurst, New York |
| Authorized Official Name and Position | Aristotle Lyssikatos (OWNER) |
| Authorized Official Contact | 9087057122 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Upper Ditmars Dental Pllc 2128 80th St East Elmhurst NY 11370-1323 Ph: () - | Upper Ditmars Dental Pllc 2128 80th St East Elmhurst NY 11370-1323 Ph: (908) 705-7122 |
| NPI Number | 1437695764 |
|---|---|
| Provider Enumeration Date | 01/10/2017 |
| Last Update Date | 01/10/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437695764 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 052126 (New York) | Primary |
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