| Ls Dental Pc | |
|
4705 44th St Apt A2 Woodside NY 11377-6301 | |
| (718) 752-9000 | |
| (718) 440-9460 |
| Full Name | Ls Dental Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4705 44th St Apt A2, Woodside, New York |
| Authorized Official Name and Position | Leonid Shimanov (DENTIST) |
| Authorized Official Contact | 7187529000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ls Dental Pc 4705 44th St Apt A2 Woodside NY 11377-6301 Ph: (718) 752-9000 | Ls Dental Pc 4705 44th St Apt A2 Woodside NY 11377-6301 Ph: (718) 752-9000 |
| NPI Number | 1609044023 |
|---|---|
| Provider Enumeration Date | 02/19/2008 |
| Last Update Date | 02/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609044023 | NPI | - | NPPES |
| 02259492 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 048978-1 (New York) | Primary |
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› Verified 7 days ago
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