Star Dental Care Ii Pc | |
1528 Main St Port Jefferson Station NY 11777-2236 | |
(631) 473-1338 | |
(631) 473-1390 |
Full Name | Star Dental Care Ii Pc |
---|---|
Speciality | Dentist |
Location | 1528 Main St, Port Jefferson Station, New York |
Authorized Official Name and Position | Shefali Marchawala (PRESIDENT) |
Authorized Official Contact | 6314731338 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Star Dental Care Ii Pc 1528 Main St Port Jefferson Station NY 11777-2236 Ph: (631) 473-1338 | Star Dental Care Ii Pc 1528 Main St Port Jefferson Station NY 11777-2236 Ph: (631) 473-1338 |
NPI Number | 1720328115 |
---|---|
Provider Enumeration Date | 02/21/2013 |
Last Update Date | 02/21/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1720328115 | NPI | - | NPPES |
01869305 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 047506-1 (New York) | Primary |
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