Organization
CHELSEA PEDIATRIC DENTISTRY LIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATASHA LARSON DMD (PRESIDENT)
(617) 913-8620
Entity
Organization
Contact information
Practice address
45-45 21ST STREET, LONG ISLAND CITY, NY 11101-5219
(718) 752-0001
Mailing address
45-45 21ST STREET, LONG ISLAND CITY, NY 11101-5219
(718) 752-0001
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
055413
NY
Other
Enumeration date
10/04/2016
Last updated
10/04/2016
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