Organization
FULTON PARK PLAZA DENTAL CARE P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMED MUKIT D.D.S. (PRESIDENT)
(718) 778-8512
Entity
Organization
Contact information
Practice address
8773 SUTPHIN BLVD, JAMAICA, NY 11435-3343
(718) 778-8512
(718) 221-2147
Mailing address
8773 SUTPHIN BLVD, JAMAICA, NY 11435-3343
(718) 291-1771
(718) 291-1772
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
041982
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01109677
—
NY
Enumeration date
02/07/2008
Last updated
10/10/2017
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