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Organization

ELITE DENTAL OF STATEN ISLAND,PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEVEN R ACKER DDS (OWNER)
(718) 370-1200
Entity
Organization

Contact information

Practice address
2291 VICTORY BLVD, STATEN ISLAND, NY 10314-6625
(718) 370-1200
(718) 370-1207
Mailing address
2291 VICTORY BLVD, STATEN ISLAND, NY 10314-6625
(718) 370-1200
(718) 370-1207

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
036474
NY
332BC3200X
Customized Equipment (DME)

Other

Enumeration date
01/06/2014
Last updated
05/20/2014
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