| X Collado Dental Center | |
|
10105 77th St Ozone Park NY 11416-1904 | |
| (718) 323-1288 | |
| (718) 323-0291 |
| Full Name | X Collado Dental Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 10105 77th St, Ozone Park, New York |
| Authorized Official Name and Position | Juana X Collado-medina (X COLLADO DENTAL CENTER) |
| Authorized Official Contact | 7183231288 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| X Collado Dental Center 10105 77th St Ozone Park NY 11416-1904 Ph: (718) 323-1288 | X Collado Dental Center 10105 77th St Ozone Park NY 11416-1904 Ph: (718) 323-1288 |
| NPI Number | 1649506353 |
|---|---|
| Provider Enumeration Date | 10/30/2009 |
| Last Update Date | 10/30/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649506353 | NPI | - | NPPES |
| 01558754 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 045798-1 (New York) | Primary |
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