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Organization
STATEN ISLAND MALL DENTAL, P.C.
Active
Organization
STATEN ISLAND MALL DENTAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSS KRASNOV D.D.S. (DENTIST)
(718) 982-5500
Entity
Organization
Contact information
Practice address
2655 RICHMOND AVENUE, 2220, STATEN ISLAND, NY 10314
(718) 982-5500
(718) 982-5554
Mailing address
2655 RICHMOND AVENUE, 2220, STATEN ISLAND, NY 10314
(718) 982-5500
(718) 982-5554
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
046-043
NY
Other
Enumeration date
05/03/2007
Last updated
08/22/2020
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