| Evan P. Mondshine, D.d.s., P.c. | |
|
6836 108th St Ste B10 Forest Hills NY 11375-3366 | |
| (718) 268-1561 | |
| (718) 268-1577 |
| Full Name | Evan P. Mondshine, D.d.s., P.c. |
|---|---|
| Speciality | Dentist |
| Location | 6836 108th St Ste B10, Forest Hills, New York |
| Authorized Official Name and Position | Evan P Mondshine (OWNER) |
| Authorized Official Contact | 7182681561 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evan P. Mondshine, D.d.s., P.c. 6836 108th St Ste B10 Forest Hills NY 11375-3366 Ph: (718) 268-1561 | Evan P. Mondshine, D.d.s., P.c. 6836 108th St Ste B10 Forest Hills NY 11375-3366 Ph: (718) 268-1561 |
| NPI Number | 1558497529 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 03/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558497529 | NPI | - | NPPES |
| 00339946 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 031513 (New York) | Primary |
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