| Elite Denal Care P.c. | |
|
9438 59th Ave Elmhurst NY 11373-5151 | |
| (718) 699-1100 | |
| (718) 699-1300 |
| Full Name | Elite Denal Care P.c. |
|---|---|
| Speciality | Dentist |
| Location | 9438 59th Ave, Elmhurst, New York |
| Authorized Official Name and Position | David Gavlin (PRES) |
| Authorized Official Contact | 7186991100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Denal Care P.c. 9438 59th Ave Elmhurst NY 11373-5151 Ph: (718) 699-1100 | Elite Denal Care P.c. 9438 59th Ave Elmhurst NY 11373-5151 Ph: (718) 699-1100 |
| NPI Number | 1154463016 |
|---|---|
| Provider Enumeration Date | 02/13/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154463016 | NPI | - | NPPES |
| 02647501 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 048412 (New York) | Primary |
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