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Organization
SAM'S FAMILY DENTAL
Active
Organization
SAM'S FAMILY DENTAL
Active
Other names
Rockaway Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDEEP BHAGAT DMD (OWNER)
(718) 429-5256
Entity
Organization
Contact information
Practice address
39-79 61 STREET ROOSEVELT AVENUE, WOODSIDE, NY 11377
(718) 429-5256
Mailing address
39-79 61ST STREET ROOSEVELT AVENUE, WOODSIDE, NY 11377
(718) 429-5256
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
048767
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02074784
—
NY
Enumeration date
06/18/2008
Last updated
06/18/2008
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