Queens Modern Dental

NPI 1083991822 - Dentist - 1223G0001X

NPI Details
NPI 1083991822
Enumeration Date 11/08/2011
Last Updated 11/08/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name LOURDES JOANNE LOURDES
Position GENERAL DENTIST
Phone (718) 217-8700
Fax (718) 217-8706
Practice Location
21820 HEMPSTEAD AVE
SUITE 2
QUEENS VILLAGE NY, 11429-1235, US
Phone (718) 217-8700
Fax (718) 217-8706
Business Location
21820 HEMPSTEAD AVE
SUITE 2
QUEENS VILLAGE NY, 11429-1235, US
Phone (718) 217-8700
Fax (718) 217-8706
Toxanomy
Taxonomy Code 1223G0001X
License State New York
License Number 050925
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According to our database, Queens Modern Dental NPI is 1083991822, taxonomy code is 1223G0001X and license number is 050925, license state is located at New York. Queens Modern Dental physically located at 21820 Hempstead Ave, Queens Village NY, 11429-1235. NPI Number 1033115704 has the healthcare provider type.

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1083991822 NPI number is provided on an as is basis without warranty of any kind. 1083991822 is maintained by the National Plan & Provider Enumeration System. The contents of Queens Modern Dental are for informational purposes only.