| Plaza Dental Pc | |
|
234 Airport Plaza Blvd Suite 3 Farmingdale NY 11735-3917 | |
| (631) 756-1900 | |
| (631) 756-1901 |
| Full Name | Plaza Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 234 Airport Plaza Blvd, Farmingdale, New York |
| Authorized Official Name and Position | Christopher M Perciballi (PRESIDENT) |
| Authorized Official Contact | 6317561900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Plaza Dental Pc 234 Airport Plaza Blvd Suite 3 Farmingdale NY 11735-3917 Ph: (631) 756-1900 | Plaza Dental Pc 234 Airport Plaza Blvd Suite 3 Farmingdale NY 11735-3917 Ph: (631) 756-1900 |
| NPI Number | 1952508707 |
|---|---|
| Provider Enumeration Date | 06/27/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952508707 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 048957 (New York) | Primary |
| 122300000X | Dentist | 050095 (New York) | Secondary |
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