Nanuet Mall Dental, P.c. | |
75 W Route 59 Suite# 1009a Nanuet NY 10954-2700 | |
(845) 624-7500 | |
(845) 624-7505 |
Full Name | Nanuet Mall Dental, P.c. |
---|---|
Speciality | Dentist - General Practice |
Location | 75 W Route 59, Nanuet, New York |
Authorized Official Name and Position | Yelena Khrapko (GENERAL DENTIST) |
Authorized Official Contact | 8456247500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Nanuet Mall Dental, P.c. 75 W Route 59 Suite# 1009a Nanuet NY 10954-2700 Ph: (845) 624-7500 | Nanuet Mall Dental, P.c. 75 W Route 59 Suite# 1009a Nanuet NY 10954-2700 Ph: (845) 624-7500 |
NPI Number | 1609093905 |
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Provider Enumeration Date | 04/19/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609093905 | NPI | - | NPPES |
02550030 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 049059 (New York) | Primary |
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