Organization
AAA UPTOWN STAR DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VALENTINA KRIVOSHEYEVA DDS (VICE PRESIDENT)
(212) 569-4652
Entity
Organization
Contact information
Practice address
680 W 204TH ST APT 1C, NEW YORK, NY 10034-3003
(212) 569-4652
(212) 569-4644
Mailing address
680 W 204TH ST APT 1C, NEW YORK, NY 10034-3003
(212) 569-4652
(212) 569-4644
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
046105
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01995757
—
NY
Enumeration date
02/13/2007
Last updated
08/22/2020
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