| Open Dental Pc | |
|
300 E 96th St Apt 6e New York NY 10128-3869 | |
| (734) 883-4406 | |
| Not Available |
| Full Name | Open Dental Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 300 E 96th St Apt 6e, New York, New York |
| Authorized Official Name and Position | Anastasia Kovaleva (OFFICE MANAGER) |
| Authorized Official Contact | 7186187564 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Open Dental Pc 300 E 96th St Apt 6e New York NY 10128-3869 Ph: (734) 883-4406 | Open Dental Pc 300 E 96th St Apt 6e New York NY 10128-3869 Ph: (734) 883-4406 |
| NPI Number | 1114332798 |
|---|---|
| Provider Enumeration Date | 06/23/2014 |
| Last Update Date | 06/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114332798 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 056676 (New York) | Primary |
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