Organization
RADIANT SMILE DENTAL CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAVEL KRASTEV (OWNER/PRESIDENT)
(516) 355-9510
Entity
Organization
Contact information
Practice address
812 JERICHO TPKE, NEW HYDE PARK, NY 11040-4514
(516) 355-9510
(516) 437-4567
Mailing address
812 JERICHO TPKE, NEW HYDE PARK, NY 11040-4514
(516) 355-9510
(516) 437-4567
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
044978
NY
Other
Enumeration date
01/06/2012
Last updated
01/06/2012
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