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Organization
BELLEROSE DENTAL P.C.
Active
Organization
BELLEROSE DENTAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IOSIF UVAYDOV DDS (OWNER)
(718) 575-1889
Entity
Organization
Contact information
Practice address
102-32 JAMAICA AVENUE, QUEENS, NY 11418
(718) 575-1889
Mailing address
72-36 112TH STREET APT.612, FOREST HILLS, NY 11375
(718) 575-1889
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
044283
NY
Other
Enumeration date
09/07/2012
Last updated
09/07/2012
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