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Organization
STATE DENTAL ARTS P.C
Active
Organization
STATE DENTAL ARTS P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LIGIA V STATE DDS (DENTIST)
(917) 815-5767
Entity
Organization
Contact information
Practice address
6715 ROOSEVELT AVE, WOODSIDE, NY 11377
(917) 815-5767
Mailing address
6715 ROOSEVELT AVE, WOODSIDE, NY 11377
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
052176
NY
Other
Enumeration date
02/26/2013
Last updated
02/26/2013
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