| Emmet Dental Pc | |
|
8902 165th St Mw 29 Jamaica NY 11432 | |
| (718) 657-4838 | |
| (718) 657-0099 |
| Full Name | Emmet Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 8902 165th St, Jamaica, New York |
| Authorized Official Name and Position | Emil Yousefnejad Korori (PRESIDENT) |
| Authorized Official Contact | 7186574838 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Emmet Dental Pc 8902 165th St Mw 29 Jamaica NY 11432 Ph: (718) 657-4838 | Emmet Dental Pc 8902 165th St Mw 29 Jamaica NY 11432 Ph: (718) 657-4838 |
| NPI Number | 1558379487 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558379487 | NPI | - | NPPES |
| 02360025 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 050370 (New York) | Primary |
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