Organization
TAN DENTAL PRACTICE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STELLA EI BE TAN D.D.S (MEMBER)
(917) 515-8226
Entity
Organization
Contact information
Practice address
6854 CLYDE ST, APT 2, FOREST HILLS, NY 11375-5038
(718) 268-2798
Mailing address
6854 CLYDE ST, APT 2, FOREST HILLS, NY 11375-5038
(718) 268-2798
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
0498641
NY
Other
Enumeration date
06/26/2008
Last updated
06/26/2008
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