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Organization
VIDA DENTAL SPA
Active
Organization
VIDA DENTAL SPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA TERESA IOANNOU DDS (DDS)
(718) 475-6789
Entity
Organization
Contact information
Practice address
1101 154TH ST, WHITESTONE, NY 11357-1954
(718) 475-6789
(718) 504-7500
Mailing address
1101 154TH ST, WHITESTONE, NY 11357-1954
(718) 475-6789
(718) 504-7500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
050794
NY
Other
Enumeration date
10/27/2016
Last updated
10/27/2016
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