| Advanced Aesthetic Dentistry | |
|
3244 E Main St Mohegan Lake NY 10547-1535 | |
| (914) 526-2144 | |
| (914) 523-2187 |
| Full Name | Advanced Aesthetic Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3244 E Main St, Mohegan Lake, New York |
| Authorized Official Name and Position | Wanda E Mejia (DENTIST) |
| Authorized Official Contact | 9145262144 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Aesthetic Dentistry 3244 E Main St Mohegan Lake NY 10547-1535 Ph: (914) 526-2144 | Advanced Aesthetic Dentistry 3244 E Main St Mohegan Lake NY 10547-1535 Ph: (914) 526-2144 |
| NPI Number | 1538370465 |
|---|---|
| Provider Enumeration Date | 05/24/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538370465 | NPI | - | NPPES |
| 048450 | Other | NY | DENTIST LIC # |
| 048615 | Other | NY | DENTIST LIC # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 048615 (New York) | Secondary |
| 1223G0001X | Dentist - General Practice | 048450 (New York) | Primary |
Mohegan Lake Dental Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1719 E Main St, Mohegan Lake, NY 10547 Phone: 914-528-2191 Fax: 914-743-1579 |