Organization
PROFESSIONAL DENTAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERNARD G RUPNARAIN DDS MSD (PRESIDENT)
(718) 728-8844
Entity
Organization
Contact information
Practice address
3119 NEWTOWN AVE, SUITE 800, ASTORIA, NY 11102-1350
(718) 728-8844
(718) 728-6795
Mailing address
3119 NEWTOWN AVE, SUITE 800, ASTORIA, NY 11102-1350
(718) 728-8844
(718) 728-6795
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
043622
NY
1223P0300X
Periodontics
Primary
046368
NY
Other
Enumeration date
11/07/2006
Last updated
09/12/2012
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