Organization
ADVANCED DENTAL OF NEW YORK PC
Active
Organization
ADVANCED DENTAL OF NEW YORK PC
Active
Other names
Advanced Dental Specialties of NY
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN KATAYEV DDS (PRESIDENT)
(718) 740-6000
Entity
Organization
Contact information
Practice address
19711 HILLSIDE AVE, HOLLIS, NY 11423-2126
(718) 740-6000
(718) 740-6004
Mailing address
197-11 HILLSIDE AVENUE, HOLLIS, NY 11423-2516
(718) 740-6000
(718) 740-6004
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
054577
NY
1223P0300X
Periodontics
053253
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
053869
NY
Other
Enumeration date
02/24/2011
Last updated
12/15/2017
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