| Corona Dental Office, Pc | |
|
10807 Corona Ave 2 Floor Corona NY 11368-3941 | |
| (718) 760-3417 | |
| (718) 760-3417 |
| Full Name | Corona Dental Office, Pc |
|---|---|
| Speciality | Dentist |
| Location | 10807 Corona Ave, Corona, New York |
| Authorized Official Name and Position | Wascar Alexi Ramirez (OWNER) |
| Authorized Official Contact | 7187603417 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Corona Dental Office, Pc 10807 Corona Ave 2 Floor Corona NY 11368-3941 Ph: (718) 760-3417 | Corona Dental Office, Pc 10807 Corona Ave 2 Floor Corona NY 11368-3941 Ph: (718) 760-3417 |
| NPI Number | 1063797009 |
|---|---|
| Provider Enumeration Date | 10/20/2011 |
| Last Update Date | 10/20/2011 |
| Medicare PECOS PAC ID | 3577872233 |
|---|---|
| Medicare Enrollment ID | O20151020000725 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063797009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0484861 (New York) | Primary |
| Provider Name | Wascar A Ramirez |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1861465726 PECOS PAC ID: 6608185871 Enrollment ID: I20151029001444 |
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