| 1037 Fulton Street Dental Pc | |
|
1037 Fulton St Farmingdale NY 11735-4700 | |
| (347) 528-8164 | |
| Not Available |
| Full Name | 1037 Fulton Street Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 1037 Fulton St, Farmingdale, New York |
| Authorized Official Name and Position | John Davydov (DIRECTOR) |
| Authorized Official Contact | 3475288164 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 1037 Fulton Street Dental Pc 1037 Fulton St Farmingdale NY 11735-4700 Ph: () - | 1037 Fulton Street Dental Pc 1037 Fulton St Farmingdale NY 11735-4700 Ph: (347) 528-8164 |
| NPI Number | 1366926891 |
|---|---|
| Provider Enumeration Date | 09/20/2018 |
| Last Update Date | 10/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366926891 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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