| Fulton Park Plaza Dental Care P C | |
|
8773 Sutphin Blvd Jamaica NY 11435-3343 | |
| (718) 778-8512 | |
| (718) 221-2147 |
| Full Name | Fulton Park Plaza Dental Care P C |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8773 Sutphin Blvd, Jamaica, New York |
| Authorized Official Name and Position | Mohammed Mukit (PRESIDENT) |
| Authorized Official Contact | 7187788512 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fulton Park Plaza Dental Care P C 8773 Sutphin Blvd Jamaica NY 11435-3343 Ph: (718) 291-1771 | Fulton Park Plaza Dental Care P C 8773 Sutphin Blvd Jamaica NY 11435-3343 Ph: (718) 778-8512 |
| NPI Number | 1073791323 |
|---|---|
| Provider Enumeration Date | 02/07/2008 |
| Last Update Date | 10/10/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073791323 | NPI | - | NPPES |
| 01109677 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 041982 (New York) | Primary |
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