Astoria Dental Group Pc | |
3217 Broadway Astoria NY 11106-2674 | |
(718) 278-1123 | |
(718) 278-6048 |
Full Name | Astoria Dental Group Pc |
---|---|
Speciality | Dentist - General Practice |
Location | 3217 Broadway, Astoria, New York |
Authorized Official Name and Position | Clifford Edward Degel (PRESIDENT) |
Authorized Official Contact | 7182781123 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Astoria Dental Group Pc 3217 Broadway Astoria NY 11106-2674 Ph: (718) 278-1123 | Astoria Dental Group Pc 3217 Broadway Astoria NY 11106-2674 Ph: (718) 278-1123 |
NPI Number | 1548484322 |
---|---|
Provider Enumeration Date | 04/12/2007 |
Last Update Date | 02/03/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1548484322 | NPI | - | NPPES |
01227738 | Medicaid | NY | |
01215461 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 042417 (New York) | Primary |
1223G0001X | Dentist - General Practice | 043236 (New York) | Secondary |
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