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Organization
VILLAGE GREEN DENTAL PC
Active
Organization
VILLAGE GREEN DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VALERY DUBOVIKOV (DDS)
(718) 948-0870
Entity
Organization
Contact information
Practice address
337 HAMPTON GRN, STATEN ISLAND, NY 10312-1722
(718) 948-0870
Mailing address
337 HAMPTON GRN, STATEN ISLAND, NY 10312-1722
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0389861
NY
Other
Enumeration date
06/06/2011
Last updated
06/06/2011
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