# 77 DENTAL PC

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

## Provider details

- **NPI number:** 1902186695
- **Authorized official:** MANOHAR K SHRESTHA DDS (PRESIDENT)
- **Authorized official phone:** (718) 779-3324

## Contact information

- **Practice address:** 37-40 77 STREET, 1ST FL, JACKSON HEIGHTS, NY 11372-6630
- **Practice address phone:** (718) 779-3324
- **Practice address fax:** (718) 779-3324
- **Mailing address:** 37-40 77 STREET, 1ST FL, JACKSON HEIGHTS, NY 11372-6630
- **Mailing address phone:** (718) 779-3324
- **Mailing address fax:** (718) 779-3324

## Taxonomy

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

## Other

- **Enumeration date:** 08/25/2011
- **Last updated:** 08/25/2011