Organization
ALAVI-LIN DENTAL PC
Active
Other names
Woodside Specialty Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMAD ALAVI DDS (PROSTHODONTIST)
(310) 713-9588
Entity
Organization
Contact information
Practice address
5123 QUEENS BLVD, OFFICE 1, DENTIST, WOODSIDE, NY 11377-4587
(718) 440-9272
(718) 440-9797
Mailing address
5123 QUEENS BLVD, OFFICE 1, DENTIST, WOODSIDE, NY 11377-4587
(718) 440-9272
(718) 440-9797
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
055123
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03362672
—
NY
Enumeration date
03/14/2013
Last updated
03/14/2013
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