| Tooth | |
|
6107 Utopia Pkwy 2fl Fresh Meadows NY 11365-2155 | |
| (718) 886-6843 | |
| (718) 886-6853 |
| Full Name | Tooth |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6107 Utopia Pkwy, Fresh Meadows, New York |
| Authorized Official Name and Position | Ahmad Barak (MANAGER) |
| Authorized Official Contact | 7188866843 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tooth 6107 Utopia Pkwy 2fl Fresh Meadows NY 11365-2155 Ph: (718) 886-6843 | Tooth 6107 Utopia Pkwy 2fl Fresh Meadows NY 11365-2155 Ph: (718) 886-6843 |
| NPI Number | 1154610160 |
|---|---|
| Provider Enumeration Date | 03/30/2011 |
| Last Update Date | 06/01/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154610160 | NPI | - | NPPES |
| 03046559 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 052876 (New York) | Primary |
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