| Dentrx, LLC | |
|
81 Randall Ave Staten Island NY 10301-2769 | |
| (848) 287-4398 | |
| Not Available |
| Full Name | Dentrx, LLC |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 81 Randall Ave, Staten Island, New York |
| Authorized Official Name and Position | Terrance Stradford (OWNER) |
| Authorized Official Contact | 8482874398 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dentrx, LLC 81 Randall Ave Staten Island NY 10301-2769 Ph: (848) 287-4398 | Dentrx, LLC 81 Randall Ave Staten Island NY 10301-2769 Ph: (848) 287-4398 |
| NPI Number | 1346826120 |
|---|---|
| Provider Enumeration Date | 03/22/2021 |
| Last Update Date | 03/22/2021 |
| Certification Date | 03/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346826120 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (NU) | Primary |
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