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Organization
ROCKAWAY FAMILY DENTISTRY PLLC
Active
Organization
ROCKAWAY FAMILY DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KOOROSH SHAMTOUB DDS (PRESIDENT)
(718) 732-7744
Entity
Organization
Contact information
Practice address
14712 ROCKAWAY BLVD, JAMAICA, NY 11436-1634
(718) 732-7744
(347) 644-1745
Mailing address
14712 ROCKAWAY BLVD, JAMAICA, NY 11436-1634
(718) 732-7744
(347) 644-1745
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
051063
NY
Other
Enumeration date
03/15/2012
Last updated
03/15/2012
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