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Organization
S T DENTAL SERVICE PC
Active
Organization
S T DENTAL SERVICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SVETLANA TERENTIEVA DDS (PRESIDENT)
(718) 327-3816
Entity
Organization
Contact information
Practice address
1908 MOTT AVE, FAR ROCKAWAY, NY 11691-4101
(718) 327-8816
(718) 327-5197
Mailing address
1908 MOTT AVE, FAR ROCKAWAY, NY 11691-4101
(718) 327-8816
(718) 327-5197
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
049077
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02110098
—
NY
01
—
9176812
DORAL
NY
Enumeration date
03/31/2006
Last updated
08/22/2020
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