Organization · NPI-2

77 Dental PC

Clinic/Center, Dental · Jackson Heights, NY

NPI number1902186695
StatusActive
Last updated in NPPESAug 25, 2011

Details

NPI
1902186695
Entity type
Organization (NPI-2)
Legal business name
77 Dental PC
Organization subpart
No
Enumeration date
Aug 25, 2011
Last updated
Aug 25, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QD0000X Clinic/Center, Dental––Yes

Practice location

37-40 77 Street
1st Fl
Jackson Heights, NY 11372-6630

Phone 718-779-3324 · Fax 718-779-3324

Mailing address

37-40 77 Street
1st Fl
Jackson Heights, NY 11372-6630

Phone 718-779-3324 · Fax 718-779-3324

Authorized official

Manohar K Shrestha
President
7187793324

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