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Organization
QUEENS MODERN DENTAL
Active
Organization
QUEENS MODERN DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOURDES JOANNE SAINT PAUL DDS (GENERAL DENTIST)
(718) 217-8700
Entity
Organization
Contact information
Practice address
21820 HEMPSTEAD AVE, SUITE 2, QUEENS VILLAGE, NY 11429-1235
(718) 217-8700
(718) 217-8706
Mailing address
21820 HEMPSTEAD AVE, SUITE 2, QUEENS VILLAGE, NY 11429-1235
(718) 217-8700
(718) 217-8706
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
050925
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02584774
—
NY
Enumeration date
11/08/2011
Last updated
11/08/2011
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