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Organization
MODERN E DENTAL
Active
Organization
MODERN E DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRACE E SHIN D.D.S (DENTIST)
(718) 281-1282
Entity
Organization
Contact information
Practice address
4823 LITTLE NECK PKWY, LITTLE NECK, NY 11362-1432
(718) 281-1282
Mailing address
4823 LITTLE NECK PKWY, LITTLE NECK, NY 11362-1432
(718) 281-1282
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
049968
NY
Other
Enumeration date
04/17/2008
Last updated
04/17/2008
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