Organization
AQUA DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUBINA KHATOON DDS (OWNER)
(315) 788-7888
Entity
Organization
Contact information
Practice address
1283 ARSENAL ST, WATERTOWN, NY 13601-2252
(315) 788-7888
(315) 788-7833
Mailing address
1283 ARSENAL ST, WATERTOWN, NY 13601-2252
(315) 788-7888
(315) 788-7833
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
052355
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02698960
—
NY
01
—
1772007
UNITED CONCORDIA
NY
Enumeration date
03/25/2008
Last updated
03/25/2008
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