5b105strdentalpc

NPI 1306052618 - Dentist - 122300000X

NPI Details
NPI 1306052618
Enumeration Date 05/15/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name JOANNA JOANNA
Position DENTIST
Phone (718) 474-0007
Fax (718) 474-0004
Practice Location
5 BEACH 105TH ST
ROCKAWAY PARK NY, 11694-2699, US
Phone (718) 474-0007
Fax (718) 474-0004
Business Location
5 BEACH 105TH ST
ROCKAWAY PARK NY, 11694-2699, US
Phone (718) 474-0007
Fax (718) 474-0004
Toxanomy
Taxonomy Code 122300000X
License State New York
License Number 046206-1
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According to our database, 5b105strdentalpc NPI is 1306052618, taxonomy code is 122300000X and license number is 046206-1, license state is located at New York. 5b105strdentalpc physically located at 5 Beach 105th St, Rockaway Park NY, 11694-2699. NPI Number 1033115704 has the healthcare provider type.

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1306052618 NPI number is provided on an as is basis without warranty of any kind. 1306052618 is maintained by the National Plan & Provider Enumeration System. The contents of 5b105strdentalpc are for informational purposes only.