Organization
HANETTE GOMEZ DENTISTRY PLLC
Active
Other names
Cosmetic Dental Image
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HANETTE S GOMEZ DDS (OWNER/DENTIST)
(718) 848-7878
Entity
Organization
Contact information
Practice address
9531 156TH AVE, HOWARD BEACH, NY 11414-2863
(718) 848-7878
(718) 848-4374
Mailing address
9531 156TH AVE, HOWARD BEACH, NY 11414-2863
(718) 848-7878
(718) 848-4374
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01281218
—
NY
Enumeration date
01/07/2021
Last updated
01/07/2021
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