Organization
ELITE NEW YORK DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK MEHRDAD HAGIGI DDS (PRESIDENT)
(347) 420-9490
Entity
Organization
Contact information
Practice address
4305 48TH AVE, WOODSIDE, NY 11377-6241
(347) 420-9490
(201) 963-3805
Mailing address
43-05 48TH AVE, WOODSIDE, NY 11377-6241
(347) 420-9490
(201) 963-3805
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
053887-1
NY
Other
Enumeration date
12/29/2008
Last updated
12/29/2008
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