| Vanguard Dental, Pllc | |
|
200 Old Country Rd Suite 520 Mineola NY 11501-4235 | |
| (516) 739-3000 | |
| Not Available |
| Full Name | Vanguard Dental, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 200 Old Country Rd, Mineola, New York |
| Authorized Official Name and Position | Shakiba Jackie Shayani (DIRECTOR) |
| Authorized Official Contact | 5167393000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vanguard Dental, Pllc 200 Old Country Rd Suite 520 Mineola NY 11501-4235 Ph: (516) 739-3000 | Vanguard Dental, Pllc 200 Old Country Rd Suite 520 Mineola NY 11501-4235 Ph: (516) 739-3000 |
| NPI Number | 1598013880 |
|---|---|
| Provider Enumeration Date | 08/17/2012 |
| Last Update Date | 08/17/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598013880 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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