Organization
2791 RICHMOND LLC
Active
Other names
Oakwood Dental Arts by the Mall
Organization subpart
No
Provider details
NPI number
Authorized official
TONI LYNN EGAN (CREDENTIALING DEPARTMENT)
(718) 979-2121
Entity
Organization
Contact information
Practice address
2791 RICHMOND AVENUE, SUITE 2, STATEN ISLAND, NY 10314
(718) 400-9002
Mailing address
2791 RICHMOND AVE STE 2, STATEN ISLAND, NY 10314-5859
(718) 400-9002
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/25/2018
Last updated
09/25/2018
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