| Mohegan Lake Dental Pc | |
|
1719 E Main St Mohegan Lake NY 10547-1356 | |
| (914) 528-2191 | |
| (914) 743-1579 |
| Full Name | Mohegan Lake Dental Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1719 E Main St, Mohegan Lake, New York |
| Authorized Official Name and Position | Ojas V. Shah (OWNER/PRESIDENT) |
| Authorized Official Contact | 9143101609 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mohegan Lake Dental Pc 1719 E Main St Mohegan Lake NY 10547-1356 Ph: (914) 528-2191 | Mohegan Lake Dental Pc 1719 E Main St Mohegan Lake NY 10547-1356 Ph: (914) 528-2191 |
| NPI Number | 1164974853 |
|---|---|
| Provider Enumeration Date | 10/27/2016 |
| Last Update Date | 10/27/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164974853 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 0556901 (New York) | Primary |
Advanced Aesthetic Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3244 E Main St, Mohegan Lake, NY 10547 Phone: 914-526-2144 Fax: 914-523-2187 |