Organization
BAYSIDE FAMILY DENTAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEV KANDOV D.D.S. (OWNER)
(718) 423-2626
Entity
Organization
Contact information
Practice address
21333 39TH AVE, SUITE 302, BAYSIDE, NY 11361-2091
(718) 423-2626
Mailing address
21333 39TH AVE, SUITE 302, BAYSIDE, NY 11361-2091
(718) 423-2626
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
055553
NY
Other
Enumeration date
11/10/2014
Last updated
11/10/2014
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