Aaa Uptown Star Dental Pc | |
680 W 204th St Apt 1c New York NY 10034-3003 | |
(212) 569-4652 | |
(212) 569-4644 |
Full Name | Aaa Uptown Star Dental Pc |
---|---|
Speciality | Dentist - General Practice |
Location | 680 W 204th St Apt 1c, New York, New York |
Authorized Official Name and Position | Valentina Krivosheyeva (VICE PRESIDENT) |
Authorized Official Contact | 2125694652 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Aaa Uptown Star Dental Pc 680 W 204th St Apt 1c New York NY 10034-3003 Ph: (212) 569-4652 | Aaa Uptown Star Dental Pc 680 W 204th St Apt 1c New York NY 10034-3003 Ph: (212) 569-4652 |
NPI Number | 1003958398 |
---|---|
Provider Enumeration Date | 02/13/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003958398 | NPI | - | NPPES |
01995757 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 046105 (New York) | Primary |
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