Dental Care Of Ridgewood, P.c. | |
5647 Myrtle Ave Ridgewood NY 11385-4744 | |
(718) 417-6300 | |
(718) 417-3535 |
Full Name | Dental Care Of Ridgewood, P.c. |
---|---|
Speciality | Clinic/center - Dental |
Location | 5647 Myrtle Ave, Ridgewood, New York |
Authorized Official Name and Position | Mariya Mamkin (RESPONSIBLE PARTY) |
Authorized Official Contact | 7184176300 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Dental Care Of Ridgewood, P.c. 5647 Myrtle Ave Ridgewood NY 11385-4744 Ph: (718) 417-6300 | Dental Care Of Ridgewood, P.c. 5647 Myrtle Ave Ridgewood NY 11385-4744 Ph: (718) 417-6300 |
NPI Number | 1578701835 |
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Provider Enumeration Date | 01/25/2009 |
Last Update Date | 01/25/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578701835 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | 054039 (New York) | Primary |
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