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Organization
QUEENS DENTAL PC
Active
Organization
QUEENS DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LUZ A CHAVEZ DDS (PRESIDENT)
(718) 657-9811
Entity
Organization
Contact information
Practice address
9030 161ST, JAMAICA, NY 11432
(718) 657-9811
(718) 657-9799
Mailing address
9030 161ST, JAMAICA, NY 11432
(718) 657-9811
(718) 657-9799
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0506501
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02427076
—
NY
Enumeration date
11/02/2005
Last updated
08/22/2020
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