| Staten Island Dental Boutique | |
|
1735 Richmond Ave Fl 2 Staten Island NY 10314-3907 | |
| (347) 596-7719 | |
| Not Available |
| Full Name | Staten Island Dental Boutique |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1735 Richmond Ave Fl 2, Staten Island, New York |
| Authorized Official Name and Position | Olena Ronan (OWNER) |
| Authorized Official Contact | 3475967719 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Staten Island Dental Boutique 81 Narrows Rd N Apt D Staten Island NY 10305-2818 Ph: (347) 596-7719 | Staten Island Dental Boutique 1735 Richmond Ave Fl 2 Staten Island NY 10314-3907 Ph: (347) 596-7719 |
| NPI Number | 1770295255 |
|---|---|
| Provider Enumeration Date | 12/16/2022 |
| Last Update Date | 12/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770295255 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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