| Dental America Pc | |
|
81 14 Queens Blvd. Elmhurst NY 11373 | |
| (718) 533-1515 | |
| (718) 289-6508 |
| Full Name | Dental America Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 81 14 Queens Blvd., Elmhurst, New York |
| Authorized Official Name and Position | Fabio Gerardo Cordero (PRESIDENT) |
| Authorized Official Contact | 7185331515 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental America Pc 8114 Queens Blvd Elmhurst NY 11373-3757 Ph: (718) 533-1515 | Dental America Pc 81 14 Queens Blvd. Elmhurst NY 11373 Ph: (718) 533-1515 |
| NPI Number | 1033227798 |
|---|---|
| Provider Enumeration Date | 08/25/2006 |
| Last Update Date | 03/26/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033227798 | NPI | - | NPPES |
| 9200032 | Other | NY | DORAL DENTAL IPA OF NY |
| 01435776 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 041162 (New York) | Primary |
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