Organization
DR. MIRYEM KANDINOV D.D.S PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MIRYEM KANDINOV D.D.S (OWNER)
(718) 261-6310
Entity
Organization
Contact information
Practice address
123-60 83 AVE, SUITE 2W, KEW GARDENS, NY 11415
(718) 261-6310
(718) 261-1085
Mailing address
123-60 83 AVE, SUITE 2W, KEW GARDENS, NY 11415
(718) 261-6310
(718) 261-1085
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
045011
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01474033
—
NY
Enumeration date
03/18/2008
Last updated
03/18/2008
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