| Roosevelt Dental Care Ii P.c. | |
|
9553 Roosevelt Ave 2nd Floor Jackson Heights NY 11372-8028 | |
| (718) 334-0431 | |
| (718) 334-0676 |
| Full Name | Roosevelt Dental Care Ii P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9553 Roosevelt Ave, Jackson Heights, New York |
| Authorized Official Name and Position | Edwin Ostiago (SECRETARY) |
| Authorized Official Contact | 7183340431 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roosevelt Dental Care Ii P.c. 9553 Roosevelt Ave 2nd Floor Jackson Heights NY 11372-8028 Ph: (718) 334-0431 | Roosevelt Dental Care Ii P.c. 9553 Roosevelt Ave 2nd Floor Jackson Heights NY 11372-8028 Ph: (718) 334-0431 |
| NPI Number | 1760672893 |
|---|---|
| Provider Enumeration Date | 07/25/2007 |
| Last Update Date | 07/25/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760672893 | NPI | - | NPPES |
| 02850695 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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