# CORONA 26 MEDICAL & DENTAL MANAGEMENT PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326807025
- **Authorized official:** ALICIA PITKOUVICH (MANAGER)
- **Authorized official phone:** (917) 391-8000

## Contact information

- **Practice address:** 10308 ROOSEVELT AVE \# 2, CORONA, NY 11368-2330
- **Practice address phone:** (718) 533-7000
- **Practice address fax:** (718) 397-8000
- **Mailing address:** 10308 ROOSEVELT AVE \# 2, CORONA, NY 11368-2330
- **Mailing address phone:** (718) 533-7000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/15/2024
- **Last updated:** 03/15/2024