| Jackson Heights Family Dental | |
|
35-60 74th Street #103 Jackson Heights NY 11372-4316 | |
| (718) 898-0300 | |
| (718) 478-1123 |
| Full Name | Jackson Heights Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 35-60 74th Street, Jackson Heights, New York |
| Authorized Official Name and Position | Charlene S Lau (OWNER) |
| Authorized Official Contact | 7188980300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Heights Family Dental 35-60 74th Street #103 Jackson Heights NY 11372-4316 Ph: (718) 898-0300 | Jackson Heights Family Dental 35-60 74th Street #103 Jackson Heights NY 11372-4316 Ph: (718) 898-0300 |
| NPI Number | 1225209828 |
|---|---|
| Provider Enumeration Date | 03/22/2008 |
| Last Update Date | 03/13/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225209828 | NPI | - | NPPES |
| 01607478 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 045627 (New York) | Primary |
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