Victory Dental Pllc

NPI 1104039965 - Dentist - 122300000X

NPI Details
NPI 1104039965
Enumeration Date 05/08/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name STEVEN H STEVEN
Position OWNER
Phone (718) 447-4510
Fax (718) 815-0249
Practice Location
1311 BAY STREET
STATEN ISLAND NY, 10305, US
Phone (718) 447-4510
Fax (718) 815-0249
Business Location
1759 VICTORY BLVD
STATEN ISLAND NY, 10314, US
Phone (718) 447-6400
Fax (718) 442-4059
Toxanomy
Taxonomy Code 122300000X
License State New York
License Number 038464
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According to our database, Victory Dental Pllc NPI is 1104039965, taxonomy code is 122300000X and license number is 038464, license state is located at New York. Victory Dental Pllc physically located at 1311 Bay Street, Staten Island NY, 10305. NPI Number 1033115704 has the healthcare provider type.

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1104039965 NPI number is provided on an as is basis without warranty of any kind. 1104039965 is maintained by the National Plan & Provider Enumeration System. The contents of Victory Dental Pllc are for informational purposes only.