| Tan Dental Practice Pllc | |
|
6854 Clyde St Apt 2 Forest Hills NY 11375-5038 | |
| (718) 268-2798 | |
| Not Available |
| Full Name | Tan Dental Practice Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 6854 Clyde St, Forest Hills, New York |
| Authorized Official Name and Position | Stella Ei Be Tan (MEMBER) |
| Authorized Official Contact | 9175158226 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tan Dental Practice Pllc 6854 Clyde St Apt 2 Forest Hills NY 11375-5038 Ph: (718) 268-2798 | Tan Dental Practice Pllc 6854 Clyde St Apt 2 Forest Hills NY 11375-5038 Ph: (718) 268-2798 |
| NPI Number | 1124280664 |
|---|---|
| Provider Enumeration Date | 06/26/2008 |
| Last Update Date | 06/26/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124280664 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 0498641 (New York) | Primary |
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