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Organization

BEACH VIEW DENTAL PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LILLY SAMUEL (OFFICE MANAGER)
(718) 471-3366
Entity
Organization

Contact information

Practice address
711B SEAGIRT AVE, FAR ROCKAWAY, NY 11691-5730
(718) 471-3366
(718) 471-3366
Mailing address
711B SEAGIRT AVE, FAR ROCKAWAY, NY 11691-5730
(718) 471-3366
(718) 471-3366

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
02631267
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02631267
NY
Enumeration date
05/16/2007
Last updated
12/23/2009
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